Recombinant human granulocyte colony stimulating factor in patients with systemic lupus erythematosus associated neutropenia and refractory infections.
OBJECTIVE
To investigate whether human recombinant granulocyte colony stimulating factor (GCSF) is capable of inducing increased neutrophil granulocyte (polymorphonuclear leukocytes, PMN) counts in patients with systemic lupus erythematosus (SLE) associated neutropenia and refractory infections.


METHODS
Nine patients with SLE associated neutropenia and concomitant refractory infections received a total of 12 cycles of 48 Mio U GCSF per day subcutaneously for an average of 6 days (range 1-17 days) as an adjunct to antibiotic treatment. In one case of impaired wound healing, longterm GCSF was applied over 148 days.


RESULTS
In each case, the average PMN count increased distinctly within 2 days from 1.3 per nl (range 0.7-2.4) to 8.4/nl (3.2-19.4). Major adverse events were exacerbation of central nervous system symptoms in 2 patients and leukocytoclastic vasculitis in one.


CONCLUSIONS
GCSF induces a rapid increase in PMN counts in patients with lupus associated neutropenia and normal or hyperplastic granulopoiesis. In 3 of 9 patients we observed a flare of lupus associated symptoms.
Euler
H H
HH
2nd Department of Internal Medicine, Christian-Albrecht University Kiel, Germany.
Harten
P
P
Zeuner
R A
RA
Schwab
U M
UM
D000328:Adult; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects / Q000627:therapeutic use*; D006098:Granulocytes / Q000187:drug effects; D006801:Humans; D007239:Infections / Q000097:blood / Q000188:drug therapy*; D007958:Leukocyte Count / Q000187:drug effects*; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000097:blood / Q000188:drug therapy*; D009504:Neutrophils / Q000187:drug effects; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use
D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor