Granulocyte-macrophage colony-stimulating factor as infection prophylaxis in high-risk oncologic surgery

• Published in: The American journal of surgery 1996-09, Vol.172 (3), p.299-302
• Main Authors: Meropol, Neal J., Petrelli, Nicholas J., Lipman, Brian J., Rodriguez-Bigas, Miguel, Hicks, Wesley, Douglass, Harold O., Smith, Judy L., Rasey, Maryanne, Blumenson, Leslie E., Vaickus, Louis, Ann Hayes, F., Agosti, Jan M.
• Format: Article
• Language: English
• Subjects: Bacterial Infections - prevention & control; Biological and medical sciences; Colonies; Colony-stimulating factor; Granulocyte-macrophage colony stimulating factor; Granulocyte-Macrophage Colony-Stimulating Factor - adverse effects; Granulocyte-Macrophage Colony-Stimulating Factor - therapeutic use; Granulocytes; Health risks; Humans; Infections; Leukocytes (neutrophilic); Medical sciences; Miscellaneous; Neoplasms - surgery; Neutrophils; Patients; Pharmacology. Drug treatments; Postoperative Complications - prevention & control; Postoperative infection; Premedication; Prophylaxis; Risk; Risk Factors; Wound infection
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/S0002-9610(96)00106-7

A method of augmenting host defenses against bacterial pathogens could result in a decrease in postoperative infections. Given its effects on leukocyte proliferation and function, it is possible that prophylactic granulocyte-macrophage colony-stimulating factor (GM-CSF) could reduce the incidence and severity of infections in high-risk surgical patients. The current study was undertaken to determine the safety and hematologic effects of perioperative GM-CSF. Cancer patients undergoing operations with a high risk of postoperative infection were treated perioperatively for 10 days with subcutaneous GM-CSF. Cohorts were treated with GM-CSF at 125 μg/m 2/day (12 patients) and 250 /μg/ m 2/day(11 patients). There were no severe or life-threatening toxicities associated with GM-CSF. Mean maximum neutrophil counts during the first 5 postoperative days were 16.3 ± 9.14 and 24.5 ± 7.60 at 125 and 250 μg/m 2, respectively ( P = 0.04). Only one wound infection was diagnosed during this study. GM-CSF may be safely administered perioperatively at doses that augment neutrophil number and function. An ongoing randomized clinical trial will determine the impact of GM-CSF on postoperative infection.