[Complete remission during administration of rhG-CSF in acute myeloblastic leukemia with pneumonia].
A 54-year-old man was admitted with pneumonia and pancytopenia (WBC 400/microliters, RBC 297 x 10(4)/microliters, Hb 10.1g/dl, Plt 5.6 x 10(4)/microliter). Bone marrow aspiration revealed a proliferation of leukemic cells (61.6%) and led the diagnosis of AML (M2). Although no antileukemic agent had been administered previously, the combination therapy of antimicrobials and rhG-CSF for the infection not only improved pneumonia, but also induced a complete remission of AML. The short-term remission was followed by the first relapse of AML, in spite of the continuous administration of rhG-CSF. The abnormal karyotype (47, XY, +8) shown in the chromosomal analysis of the bone marrow cells at admission remained on the first remission. The second complete remission was induced by combination chemotherapy (BHAC-DMP), and the chromosomal analysis at this time showed a normal karyotype. These findings suggested that the first remission of AML in this case was caused mainly by the maturation induction effect of rhG-CSF on the leukemic cells, however, the possibility of the spontaneous remission in this case also remained.
Hayatsu
K
K
Department of Internal Medicine, Niigata Prefectural Central Hospital.
Nagai
K
K
Abe
A
A
Murakawa
E
E
Sekiya
M
M
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003561:Cytarabine / Q000008:administration & dosage / Q000031:analogs & derivatives; D003630:Daunorubicin / Q000008:administration & dosage; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications* / Q000188:drug therapy; D008297:Male; D015122:Mercaptopurine / Q000008:administration & dosage; D008875:Middle Aged; D010198:Pancytopenia / Q000209:etiology / Q000628:therapy; D011014:Pneumonia / Q000209:etiology / Q000628:therapy*; D011239:Prednisolone / Q000008:administration & dosage; D011994:Recombinant Proteins / Q000627:therapeutic use; D012074:Remission Induction
D011994:Recombinant Proteins; D003561:Cytarabine; D016179:Granulocyte Colony-Stimulating Factor; D011239:Prednisolone; D015122:Mercaptopurine; D003630:Daunorubicin