Long-term treatment with GM-CSF in patients with chronic lymphocytic leukemia and recurrent neutropenic infections.

Abstract

In this prospective study we evaluated the multiple effects of long-term GM-CSF therapy on blood counts, granulocyte functions and disease progression in patients with chronic lymphocytic leukemia (CLL) with chronic neutropenia and recurrent bacterial infections. The treatment duration varied from 2 to 12 weeks. The neutrophil count was raised in all patients, by the median of 6.6-fold. The neutrophil level of 1.0 x 10(9)/l was usually reached after two weeks. The initial dose of GM-CSF was 5 microg/kg/day, and 1-7 microg/kg/day was required to maintain the neutrophil level above 1.0 x 10(9)/l. Granulocyte functions, i.e. chemiluminescence (CL), random migration, and fMLP-stimulated chemotaxis were initially depressed in all patients when compared to healthy controls. GM-CSF enhanced significantly CL even when given at small doses (less than 1 microg/kg/day), even lower than the dose required to promote granulopoiesis. We conclude that GM-CSF is effective in improving CLL associated chronic neutropenia and also enhances impaired granulocyte chemiluminescence. Thus, GM-CSF could be helpful for giving chemotherapy without neutropenic delays and for prophylaxis of infectious complications in CLL patients.

• Authors: M Itälä, T T Pelliniemi, K Remes, S Vanhatalo, O Vainio
• Journal: Leukemia & lymphoma (Leuk Lymphoma) Vol. 32 Issue 1-2 Pg. 165-74 (Dec 1998) ISSN: 1042-8194 [Print] United States
• PMID: 10037012 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• N-Formylmethionine Leucyl-Phenylalanine
• Granulocyte-Macrophage Colony-Stimulating Factor

Topics

• Aged
• Bacterial Infections (complications, prevention & control, therapy)
• Blood Platelets (drug effects)
• Chemotaxis (drug effects)
• Female
• Granulocyte-Macrophage Colony-Stimulating Factor (adverse effects, therapeutic use)
• Granulocytes (drug effects)
• Humans
• Leukemia, Lymphocytic, Chronic, B-Cell (complications, therapy)
• Leukocyte Count (drug effects)
• Lymph Nodes (drug effects)
• Lymphocyte Subsets (drug effects)
• Male
• Middle Aged
• N-Formylmethionine Leucyl-Phenylalanine (pharmacology)
• Neutropenia (etiology, therapy)
• Prospective Studies
• Time