title: Recombinant human interleukin-3 administered concomitantly with chemotherapy in patients with relapsed small cell lung cancer.
abstract: Although recombinant human interleukin-3 (rhIL-3) shortens both the duration of chemotherapy-induced neutropenia and thrombocytopenia, its effect on nadir counts is limited. Concurrent administration of rhIL-3 and chemotherapy may enhance this effect. However, simultaneous administration of other hematopoietic growth factors and chemotherapy has resulted in enhanced myelosuppression. We investigated whether concomitant administration of rhIL-3 and chemotherapy would result in enhanced myelosuppression. Twelve patients with relapsed small cell lung cancer received vincristine, ifosfamide, mesna, and carboplatin on day 1 every four weeks. RhIL-3 was administered subcutaneously on days 1-14 during cycle 1 at doses of 4 (three patients) or 8 micrograms/kg/day (nine patients). During cycle 2 patients received only chemotherapy. No significant difference in leukocyte (1.4 +/- 1.0 vs. 0.9 +/- 0.4 x 10(9)/l (mean +/- SD), neutrophil (0.5 +/- 0.6 vs. 0.2 +/- 0.2 x 10(9)/l), and platelet (64 +/- 60 vs. 38 +/- 58 x 10(9)/l) nadir counts were demonstrated. The hemoglobin nadir level was significantly higher during cycle 1 (6.5 +/- 1.1 vs. 5.5 +/- 0.9 mmol/l, P = 0.05). Both leukocyte and platelet recovery were significantly enhanced in the rhIL-3 cycle. There was no significant difference in chemotherapy postponement or platelet transfusions. As a result of severe headaches, rhIL-3 administration was discontinued in one patient at 8 micrograms. RhIL-3 during this chemotherapy regimen for relapsed small cell lung cancer did not enhance myelotoxicity but did improve bone marrow recovery. This observation may increase the application of rhIL-3, for instance in combination with other hematopoietic growth factors.
authors.affiliation: Department of Pulmonology, University Hospital, Free University of Amsterdam, The Netherlands.
authors.forename: Bonne
authors.initials: B
authors.lastname: Biesma
authors.forename: Klaas W
authors.initials: KW
authors.lastname: van Kralingen
authors.forename: Rob W
authors.initials: RW
authors.lastname: van Leen
authors.forename: Maria C
authors.initials: MC
authors.lastname: Koster
authors.forename: Pieter E
authors.initials: PE
authors.lastname: Postmus
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D018288:Carcinoma, Small Cell / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D007377:Interleukin-3 / Q000008:administration & dosage* / Q000009:adverse effects; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D015080:Mesna / Q000008:administration & dosage; D008875:Middle Aged; D011994:Recombinant Proteins / Q000008:administration & dosage; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D007377:Interleukin-3; D011994:Recombinant Proteins; D014750:Vincristine; D016190:Carboplatin; D015080:Mesna; D007069:Ifosfamide