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.
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. ;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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