First use of myeloid colony-stimulating factors in humans

摘要

It is widely believed that the first use of myeloid colony-stimulating factors in humans was sargramostim (GM-CSF) in victims of the Goiania, Brazil radiation accident in 1987. GM-CSF was later approved by US FDA in 1991, as was filgrastim (G-CSF). However, with the recent release of previously classified documents from the ex-Soviet Union, we are now able to correct the historical record.In May 1986, we and colleagues at Clinical Hospital 6 in Moscow treated about 200 emergency personnel exposed to high-dose radiation at the Chernobyl Nuclear Power Facility.2 Six weeks after the accident, three persons who received an estimated dose of 5 Gy and only supportive care continued to have severe granulocytopenia with life-threatening lung disease, likely from radiation pneumonitis and infection(s), which was unresponsive to antibiotics and anti-fungal and anti-viral drugs.We considered therapy with GM-CSF, which had been successfully tested in animals, including sub-human primates, but not in humans. We contacted Sandoz Pharma (Basel; Dr Angelica Stern) asking for GM-CSF; the company agreed. One of us (AV) invoked his authority as a member of the special Soviet Government Commission, which enabled him to make extraordinary medical decisions in response to the Chernobyl accident. The GM-CSF was shipped to Moscow.