The effects of recombinant human granulocyte-macrophage colony-stimulating factor on phagocyte kinetics in man.

Four patients with advanced resistant malignant disease received recombinant human granulocyte-macrophage colony stimulating factor (rhGM-CSF) for 10 days. All developed a moderate neutrophilia and monocytosis over this period. A transient phagocytopenia was observed during the first hour of administration. Radionuclide labelling studies showed that this cytopenia was due to sequestration predominantly within the lungs and that the recovery was due to re-entry of the same cells into the circulation. Studies of neutrophil lobularity during this time showed no reduction in lobe count suggesting that there had been little if any release of immature cells from bone marrow reserves. Skin window responses were present in 2 out of 3 patients during the period of neutropenia showing that cells were also present in the marginated pool of the skin at this time.