Serum TNF-alpha, gamma-INF, G-CSF and GM-CSF levels in neutropenic children with acute leukemia treated with short-course, high-dose methylprednisolone

Abstract

High-dose methylprednisolone (HDMP, 20–30 mg/kg/day po) treatment has been shown to increase the number of bone marrow and peripheral blood CD34 positive progenitors and serum granulocyte-macrophage colony-stimulating factor (GM-CSF) levels in patients with ALL and AML. To investigate the effect of HDMP on some other hematopoietic regulatory cytokines, tumor necrosis factor-alpha (TNF-alpha), gamma-interferon (gamma-INF), granulocyte colony-stimulating factor (G-CSF) and interleukin-6 (IL-6) were studied by microplate ELISA technique in 15 chemotherapy-induced neutropenic episodes of 14 children with acute leukemia (eight with ALL and six with AML) in whom HDMP was given alone (30 mg/kg/day po) for 4 days. The absolute neutrophil counts increased significantly in all neutropenic episodes on the fourth day of HDMP treatment. The TNF-alpha was 93.5 ± 161 pg/ml in ALL and 78.3 ± 61.4 pg/ml in AML before treatment and 76.1 ± 160 pg/ml in ALL and 19.1 ± 39.8 pg/ml in AML after treatment. The gamma-INF was 204.1 ± 210.3 pg/ml in ALL and 130.8 ± 138.3 pg/ ml in AML before treatment and 28.6 ± 50.5 pg/ml in ALL and 23.3 ± 20.4 pg/ml in AML after treatment ( P < 0.05). Serum G-CSF and GM-CSF levels increased in all episodes (100%). The GM-CSF levels increased from 12.2 ± 10.9 pg/ml to 36 ± 24.7 pg/ml after treatment in ALL ( P < 0.05) and from 13.3 ± 4 pg/ml to 45 ± 48.1 pg/ml in AML ( P < 0.05). Serum G-CSF levels increased from 13.3 ± 11.7 pg/ml to 83.3 ± 86.8 pg/ml after treatment in ALL ( P < 0.05) and from 6.6 ± 12.1 pg/ml to 28.3 ± 11.3 pg/ml in AML ( P < 0.05). However, IL-6 levels were undetectable in all patients before and after therapy. These preliminary data suggest that short-course HDMP treatment could decrease serum TNF-alpha and gamma-INF and increase G-CSF and GM-CSF levels.