The goals of this project are to explore the uses of recombinant cytokines in reducing morbidity associated with allogeneic bone marrow transplantation (BMT). The studies proposed derive from pilot studies which have explore the use of rhGM-CSF in graft failure following BMT, and shown the safety and possible efficacy of rhGM-CSF used following allogeneic BMT initially from related, and more recently from unrelated donors. We have also explore the use of rhM-CSF in refractory, deep-seated mycotic infections. The proposed initial studies include randomized, placebo controlled trials of rhGM-CSF in allogeneic BMT, a pilot study of rhG-CSF following allogeneic BMT, a study of rhIL-1 in refractory marrow graft failure, and a Phase II study of rhM-CSF in fungal disease. Future trials depend on the outcomes of current Phase III studies and will involve combinations of cytokines and cytokines used in combination with other drugs that may modify morbidity such as pentoxifylline.
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