Granulocyte colony-stimulating factor (rh G-CSF) as an adjunct to interferon alpha therapy of neutropenic patients with hairy cell leukemia.
Six patients with hairy cell leukemia (HCL) and neutropenia (median neutrophil count 563/microliters, range 30-1200) were treated with recombinant human granulocyte colony-stimulating factor (G-CSF) at a dose of 5 micrograms/kg by daily subcutaneous injection as an adjunct to interferon-alpha (IFN-a) therapy, in order to ameliorate neutropenia. Five of six patients responded to G-CSF with normalization of neutrophil counts (> 1800/microliters) within 2-11 days and a median neutrophil count of 5211/microliters (range 4312-10160) at the end of G-CSF therapy. In three of these patients, infections resolved when neutropoiesis recovered. In one patient with very severe neutropenia (30/microliters), in whom myeloid progenitors were not detectable, G-CSF therapy failed to restore granulopoiesis. Cessation or interruption of G-CSF after 2-5 weeks of therapy resulted in a rapid decline of neutrophil counts to lower or subnormal levels (median value 1478/microliters, range 770-2739) within 1 week, suggesting that the improvement of granulopoiesis was dependent on G-CSF and not due to IFN-a therapy. G-CSF may be a useful adjunct to IFN-a therapy in patients with HCL in order to manage or prevent neutropenic complications in the early phase of treatment.
Lorber
C
C
First Department of Internal Medicine, University of Vienna, Austria.
Willfort
A
A
Ohler
L
L
Jäger
U
U
Schwarzinger
I
I
Lechner
K
K
Geissler
K
K
D000328:Adult; D004359:Drug Therapy, Combination; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006098:Granulocytes / Q000502:physiology; D006410:Hematopoiesis / Q000187:drug effects; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D007943:Leukemia, Hairy Cell / Q000150:complications* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000150:complications* / Q000188:drug therapy*; D010976:Platelet Count / Q000187:drug effects; D011994:Recombinant Proteins / Q000627:therapeutic use
D016898:Interferon-alpha; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor