The implications of granulocyte-monocyte colony-stimulating factor (GM-CSF) in cytotoxicity of bone marrow transplantation.

One of the major obstacles to the successful outcome of autologous bone marrow transplantation (ABMT) is the high relapse rate, which is most likely due to the lack of a graft-versus-tumor effect. The amplification of cell-mediated effector mechanisms against residual tumor cells is one of the ways to reduce relapse rates post ABMT at the stage of minimal residual disease. Granulocyte-monocyte colony-stimulating factor (GM-CSF) is a key cytokine that plays a major role in cytotoxicity and in the activation pathways of monocytes, macrophages, dendritic cells and tumor-infiltrating lymphocytes. Therefore it may be used for manipulating the immune system to fight against cancer. The activities of GM-CSF on monocytes-macrophages, dendritic cells and recruited components of the immune system are described in the context of the development of improved strategies for conferring enhanced resistance to a tumor-bearing host following autologous or allogeneic bone marrow transplants.