Combination therapy with recombinant human granulocyte colony-stimulating factor and erythropoietin in aplastic anemia.
Recombinant human granulocyte colony-stimulating factor (rhG-CSF) and erythropoietin (rhEPO) were used to treat patients with aplastic anemia (AA). In terms of effects on erythrocyte recovery, the combined use of rhG-CSF and rhEPO showed a favorable response in 6 of 14 (42.9%) patients with moderate AA following 10 weeks treatment and in 3 of 14 (21.4%) patients thereafter. However, the response was poor in patients with severe AA (3/13). A favorable response in severe AA was observed in 1 of 13 (7.7%) patients following 10 weeks treatment and in 2 of 13 (15.4%) patients thereafter. The overall effect on erythrocytes was observed in 44.4% patients. A dose of 400 micrograms/m2 G-CSF was sufficient to cause an increase in neutrophil count and 100 IU/kg rhEPO appeared to be sufficient to cause an increase in erythrocyte count. In 6 of 27 (22.2%) patients, a trilineage response was observed. Interestingly, a delayed and long-lasting effect was obtained in 5 of 27 (18.5%) patients. These results suggest that rhG-CSF can synergize with rhEPO in erythrocyte response, especially in patients with moderate AA.
Imamura
M
M
Third Department of Internal Medicine, Hokkaido University School of Medicine, Japan.
Kobayashi
M
M
Kobayashi
S
S
Yoshida
K
K
Mikuni
C
C
Ishikawa
Y
Y
Matsumoto
S
S
Sakamaki
S
S
Niitsu
Y
Y
Hinoda
Y
Y
D000328:Adult; D000741:Anemia, Aplastic / Q000097:blood / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D004906:Erythrocyte Count / Q000187:drug effects; D004921:Erythropoietin / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007958:Leukocyte Count / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000187:drug effects; D011994:Recombinant Proteins / Q000627:therapeutic use
D011994:Recombinant Proteins; D004921:Erythropoietin; D016179:Granulocyte Colony-Stimulating Factor