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Japanese Journal of Clinical Oncology 21:169-175 (1991)
© 1991 Foundation for Promotion of Cancer Research

research-article

Clinical Effect of Granulocyte Colony-stimulating Factor on Neutrophils and Leukemic Cells in Myelogenous Leukemia: Analysis

Jun Ishikawa1,*, Masafumi Yoshimura1, Tatsuro Matsunashi1, Nobuhiko Tominaga1, Hirofumi Teshima1, Akira Hiraoka1, Hiroyuki Nakamura1, Hirotoshi Shibata1, Tohru Masaoka1 and Fumimaro Takaku2

1Fifth Department of Internal Medicine, Center for Adult Diseases Osaka, 3-3, Nakamichi 1-chome, Higashinariku, Osaka 537
2Third Department of Internal Medicine, Faculty of Medicine, University of Tokyo 3-1 Hongo 7-chome, Bunkyo-ku, Tokyo 113

*For reprints and all correspondence

Received July 11, 1990; accepted February 9, 1991

Clinical experiences with recombinant granulocyte colony-stimulating factor (rhG-CSF) in 13 acute (AML) and four chronic (CML) myelogenous leukemia patients are reported. Sixteen patients received rhG-CSF in support of treatment for life threatening infections and one CML patient in support of induction chemotherapy. After their first induction chemotherapy, six out of eight AML patients showed a rapid increase of neutrophils, recovered from infections and achieved complete remission (CR). One patient, in whom both neutrophils and blasts had increased during rhG-CSF administration, achieved CR through the next administration of chemotherapy (CR rate 87.5%). The last of the eight AML patients showed no increase of neutrophils, and died of interstitial pneumonitis. Two of five AML patients who received rhG-CSF after reinduction chemotherapy for relapsed or refractory leukemia achieved CR, a rate of 40%. In one of the two, the administration of rhG-CSF prior to induction chemotherapy seemed advantageous in achieving CR. During rhG-CSF administration, an increase of blastic cells in peripheral blood was observed in four out of all 13 AML patients. One of three CML patients, with a lymphoid crisis, showed an increase only of neutrophils, and recovered from infection. The other two showed increases of both neutrophils and blasts. One patient with CML in blastic crisis, under going induction chemotherapy with rhG-CSF administration, returned to the chronic phase. These clinical experiences suggest rhG-CSF to be effective in supporting infection therapy and in possibly enhancing the sensitivity of myelogenous leukemic blasts to antileukemic agents.

Key Words: Granulocyte colony-stimulating factor • Myelogenous leukemia • Infection • Sensitivity to antileukemic agent


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