rhGM-CSFameliorates neutropenia inpatients withmalignant glioma treated withBCNU

Summary Nitrosoureas are the drugs most effective in the treatment ofpatients with intracerebral malignantglioma. Their limiting toxicity is delayed myelosuppression. Aprospective, randomised crossover study ofrecombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) was performed in patients receiving BCNU for relapsed glioblastoma, to investigate whether the resulting haematologicaltoxicity profile could be modified by rhGM-CSF. Adequate data for analysis were obtained in 13 patients.Following BCNU, the nadir neutrophil count was higher in 12 out of 13 patients during the rhGM-CSF-protected cycles compared with the unprotected cycles. The median nadir was also significantly higher (1.79,CI 0.76-3.52, P<0.005). Five episodes ofneutropenia (<2 x 109 1-) occurred during the unprotected cyclescompared with none in the rhGM-CSF-protected cycles (P = 0.076). There was no evidence of any effect on platelets. This result shows that the haematological toxicity profile following therapeutic doses ofBCNU