Therapy for neutropenia in hairy cell leukemia with recombinant human granulocyte colony-stimulating factor.
OBJECTIVE
To determine whether recombinant human granulocyte colony-stimulating factor (G-CSF) is effective in increasing neutrophil counts in patients with hairy cell leukemia and neutropenia.


METHODS
Open label, phase I/II study of G-CSF, given by daily subcutaneous injection for up to 7 weeks.


METHODS
Outpatient oncology clinic of a university medical center.


METHODS
A consecutive sample of four patients with hairy cell leukemia complicated by severe neutropenia. Three patients completed the study; one patient was removed after 2 weeks of therapy.


METHODS
Granulocyte colony-stimulating factor was given by daily subcutaneous injection. Each patient began therapy with 1 microgram/kg body weight.d; after 1 week the dose was increased to 3 micrograms/kg.d, and 1 week later to 6 micrograms/kg.d. Therapy was continued for 5 to 6 weeks. Patients were taught self-injection, and administered treatment at home.


RESULTS
In three patients, an increase in absolute neutrophil counts from less than 0.9 X 10(9)/L to greater than 4.0 X 10(9)/L was noted within 2 weeks of beginning G-CSF therapy. In two patients, infections resolved during therapy. One patient developed acute neutrophilic dermatosis (the Sweet syndrome) while receiving 3 micrograms/kg.d of G-CSF, and drug therapy was discontinued.


CONCLUSIONS
Granulocyte colony-stimulating factor may increase neutrophil counts within 2 weeks in patients with hairy cell leukemia and neutropenia. This therapy may be a useful adjunct to definitive treatment of hairy cell leukemia with interferon or pentostatin.
Glaspy
J A
JA
University of California, Los Angeles School of Medicine.
Baldwin
G C
GC
Robertson
P A
PA
Souza
L
L
Vincent
M
M
Ambersley
J
J
Golde
D W
DW
D000380:Agranulocytosis / Q000628:therapy*; D000920:Antibody-Dependent Cell Cytotoxicity; D003115:Colony-Stimulating Factors / Q000009:adverse effects / Q000627:therapeutic use*; D003602:Cytotoxicity, Immunologic; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor; D006801:Humans; D007943:Leukemia, Hairy Cell / Q000097:blood* / Q000276:immunology; D008297:Male; D009503:Neutropenia / Q000276:immunology / Q000628:therapy*; D009504:Neutrophils / Q000276:immunology; D009894:Opportunistic Infections / Q000628:therapy; D010587:Phagocytosis; D010865:Pilot Projects; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D012871:Skin Diseases / Q000209:etiology
D003115:Colony-Stimulating Factors; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor