Application of Human Recombinant Granulocyte Coloni-Stimulating Factor (rHU-G-CSF) Onto Patients with Medicamentally and Radiately Provoked Neutropenia and Aplastic Anaemia

Abstract

The effect of rHu-G-CSF on neutrophile restoration in 85 patients was studied. The patients were: 29 with acute lymphoblastic leucemia (ALL), 6 with acute non-lymphoblastic leucemia (ANLL), 1 with chronic myelogeneic leucemia in blast-transformation, 12 with non-Hodgkin lympho-ma (NHL), 16 with carcinoma, 10 with aplastic anaemia (AA), 10 with post-radiation neutropenia (PRN) and 1 with Kostmann’s syndrome. The daily dose of rHu-G-CSF was 5mcg/kg for all cases with haematologic malignancies, whereas the patient with Kostmann’s syndrome was treated with higher dose, up to 20mcg/kg, due to lack of effect at the end of first week. A dose of 10mcg/kg was applied to patients with aplastic anaemia and post-radiation neutropenia. The mean back-ground level of leucocytes just before treatment was 0.73 + 0.13× 10/l and that one of neutrophiles was 0.17 + 0.09× 10/l. Meanwhile the therapy the authors registered constantly: leucocyte and granulocyte quantity, some enzymes, body temperature and clinical status of the patients. The treatment was discontinued when the absolute neutrophile spectre reached over 1.0× 10/l. Shortest application was reported for the carcinoma cases: 4.3 days averagely, followed by ALL: 5.8 days, NHL: 6.3 days, ANLL 7.4 days, PRN: 10.3 days, AA: 14.5 days. One (with ALL) of treated 75 patients had a lethal issue meanwhile the therapy, another one (with ALL too) shew a recidival manifestation; 68 of the rest 73 patients demonstrated a total recovery and 5 a particular one (increase of ANC with over 100%). Only 5 patients of the group registered rapidlyprogressive side effects: 2 with muscular-skeletal pain, 2 with headaches and 1 with vomitting. The nosologic cases were thoroughly analysed which proved that rHu-G-CSF shortened considerably the time for recovery from leucopenia (opportunity for the so called ‘antibiotic umbrella’ in neutropenic patients), thus allowing effective results from the treatment of clinically manifested infectious complications and intensification of chemotherapy.