1. Sargramostim (rhu GM-CSF) Improves Survival of Non-Human Primates with Severe Bone Marrow Suppression after Acute, High-Dose, Whole-Body Irradiation.
- Author
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Clayton NP, Khan-Malek RC, Dangler CA, Zhang D, Ascah A, Gains M, Gardner B, Mockbee C, Keutzer JM, McManus J, and Authier S
- Subjects
- Acute Radiation Syndrome genetics, Acute Radiation Syndrome pathology, Animals, Bone Marrow drug effects, Bone Marrow Cells radiation effects, Bone Marrow Failure Disorders genetics, Bone Marrow Failure Disorders pathology, Cell Differentiation drug effects, Cell Differentiation radiation effects, Cell Movement drug effects, Cell Movement radiation effects, Cell Proliferation drug effects, Cell Proliferation radiation effects, Granulocyte Colony-Stimulating Factor, Hematopoietic Stem Cells drug effects, Humans, Macaca mulatta genetics, Male, Recombinant Proteins pharmacology, Whole-Body Irradiation adverse effects, Acute Radiation Syndrome drug therapy, Bone Marrow Cells drug effects, Bone Marrow Failure Disorders drug therapy, Granulocyte-Macrophage Colony-Stimulating Factor pharmacology
- Abstract
Exposure to acute, high-dose, whole-body ionizing radiation results in bone marrow failure (hematopoietic acute radiation syndrome with resultant infection, bleeding, anemia, and increased risk of death). Sargramostim (yeast-derived rhu GM-CSF), a yeast-derived, molecularly cloned, hematopoietic growth factor and pleiotropic cytokine supports proliferation, differentiation, maturation and survival of cells of several myeloid lineages. We evaluated the efficacy of sargramostim in non-human primates (rhesus macaques) exposed to whole-body ionizing radiation at a 50-60% lethal dose. The primary end point was day 60 survival. Non-human primates received daily subcutaneous sargramostim (7 mcg/kg/day) or control. To reflect the anticipated setting of a nuclear or radiologic event, treatment began 48 h postirradiation, and non-human primates received only moderate supportive care (no whole blood transfusions or individualized antibiotics). Sargramostim significantly increased day 60 survival to 78% (95% confidence interval, 61-90%) vs. 42% (26-59%; P = 0.0018) in controls. Neutrophil, platelet and lymphocyte recovery rates were accelerated and infection rates decreased. Improved survival when sargramostim was started 48 h postirradiation, without use of intensive supportive care, suggests sargramostim may be effective in treating humans exposed to acute, high-dose whole-body, ionizing radiation in a scenario such as a mass casualty event., (©2021 by Radiation Research Society. All rights of reproduction in any form reserved.)
- Published
- 2021
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