John A. Glaspy, MD; Gayle C. Baldwin, PhD; Paul A. Robertson, MD; Lawrence Souza, PhD; Martha Vincent, PhD; Janice Ambersley, RN; David W. Golde, MD
Study Objective: To determine whether recombinant human granulocyte colony-stimulating factor (G-CSF) is effective in increasing neutrophil counts in patients with hairy cell leukemia and neutropenia.
Design: Open label, phase I/II study of G-CSF, given by daily subcutaneous injection for up to 7 weeks.
Setting: Outpatient oncology clinic of a university medical center.
Patients: A consecutive sample of four patients with hairy cell leukemia complicated by severe neutropenia. Three patients completed the study; one patient was removed after 2 weeks of therapy.
Interventions: Granulocyte colony-stimulating factor was given by daily subcutaneous injection. Each patient began therapy with 1 µg/kg body weight ·d; after 1 week the dose was increased to 3 µg/kg ·d, and 1 week later to 6 µg/ kg ·d. Therapy was continued for 5 to 6 weeks. Patients were taught self-injection, and administered treatment at home.
Measurements and main results: In three patients, an increase in absolute neutrophil counts from less than 0.9 X 10/L to greater than 4.0 X 10/L was noted within 2 weeks of beginning G-CSF therapy. In two patients, infections resolved during therapy. One patient developed acute neutrophilic dermatosis (the Sweet syndrome) while receiving 3 µg/kg ·d of G-CSF, and drug therapy was discontinued.
Conclusions: Granulocyte colony-stimulating factor may increase neutrophil counts within 2 weeks in patients with hairy cell leukemia and neutropenia. This therapy may be a useful adjunct to definitive treatment of hairy cell leukemia with interferon or pentostatin.
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Glaspy JA, Baldwin GC, Robertson PA, Souza L, Vincent M, Ambersley J, et al. Therapy for Neutropenia in Hairy Cell Leukemia with Recombinant Human Granulocyte Colony-Stimulating Factor. Ann Intern Med. 1988;109:789-795. doi: 10.7326/0003-4819-109-10-789
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Published: Ann Intern Med. 1988;109(10):789-795.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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