Correction of neutropenia by GM-CSF in patients with a large granular lymphocyte proliferation.
The in vivo and in vitro effects of GM-CSF were tested in four patients with large granular lymphocyte proliferation (LGLP) and severe granulocytopenia. All patients had an increased percentage of LGL cells (greater than 20%), whereas 3/4 patients demonstrated rearranged T-cell-receptor genes. An effect on the peripheral granulocyte counts was noticed in 3/4 patients after 14 days of GM-CSF administration (5 micrograms/kg/day, subcutaneously); 2.5, 7, and 0.45 x 10(9)/l, respectively. These changes were associated with a two- to five-fold increase in monocytes and a strong increment in eosinophils. In one patient GM-CSF was not effective in increasing the granulocyte count. B lymphocytes showed a variable increase, ranging from 1.2-fold to 3.8-fold, while the number of NK cells remained almost constant during the GM-CSF treatment. No consistent effect of GM-CSF on T lymphocytes was observed. These data suggest that GM-CSF may be a therapeutic option in some patients with LGLP complicated by granulocytopenia and/or infection.
Mulder
A B
AB
Department of Hematology, University of Groningen, The Netherlands.
de Wolf
J T
JT
Smit
J W
JW
van Oostveen
J W
JW
Vellenga
E
E
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002455:Cell Division; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000627:therapeutic use*; D006801:Humans; D016130:Immunophenotyping; D007694:Killer Cells, Natural / Q000166:cytology*; D016131:Lymphocyte Subsets / Q000187:drug effects; D008875:Middle Aged; D008968:Molecular Conformation; D009503:Neutropenia / Q000097:blood / Q000188:drug therapy* / Q000276:immunology; D010641:Phenotype; D011948:Receptors, Antigen, T-Cell / Q000737:chemistry / Q000235:genetics; D011994:Recombinant Proteins / Q000627:therapeutic use
D015415:Biomarkers; D011948:Receptors, Antigen, T-Cell; D011994:Recombinant Proteins; D016178:Granulocyte-Macrophage Colony-Stimulating Factor