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Therapy for Neutropenia in Hairy Cell Leukemia with Recombinant Human Granulocyte Colony-Stimulating Factor

John A. Glaspy, MD; Gayle C. Baldwin, PhD; Paul A. Robertson, MD; Lawrence Souza, PhD; Martha Vincent, PhD; Janice Ambersley, RN; and David W. Golde, MD
[+] Article, Author, and Disclosure Information

Grant support: Supported in part by grants CA 32737 and CA 30388 from the National Institutes of Health, State of California University-wide Task Force on AIDS, and by a contract from Amgen Inc., Thousand Oaks, California.

Requests for Reprints: John A. Glaspy, MD, Room 42-121 CHS, UCLA School of Medicine, 10833 Le Conte Avenue, Los Angeles, California 90024-1678.

Current Author Addresses: Drs. Glaspy, Baldwin, and Ms. Ambersley: Room 42-121, UCLA School of Medicine, 10833 Le Conte Avenue, Los Angeles, CA 90024-1678,

Dr. Robertson: Room 42-158, UCLA School of Medicine, 10833 Le Conte Avenue, Los Angeles, CA 90024-1678.

Drs. Souza and Vincent: 1900 Oak Terrace Lane, Thousand Oaks, CA 91320.

Dr. Golde: Room 37-068 CHS, UCLA School of Medicine, 10833 Le Conte Avenue, Los Angeles, CA 90024-1678.

© 1988 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1988;109(10):789-795. doi:10.7326/0003-4819-109-10-789
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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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