Lineage-unrestricted hematologic response to granulocyte colony-stimulating factor in a patient with refractory anemia with excess blasts.

Abstract

We report a patient with refractory anemia with excess blasts who showed a lineage-unrestricted hematologic response to granulocyte colony-stimulating factor (G-CSF). After 17 months of a stable disease state, the patient developed pneumonia, progression of cytopenia, and reduced cellularity and blast mass in the bone marrow. He was given G-CSF to overcome the pneumonia. Not only the neutrophil count, but also the platelet count increased soon after initiation of the G-CSF therapy; both counts became normal on the fifth day of the G-CSF therapy. Additionally, the anemia improved gradually. The neutrophil and platelet counts were maintained in the normal range for 3 months after cessation of the G-CSF. In vitro studies showed that G-CSF alone stimulated megakaryocyte colony formation from bone marrow mononuclear cells (BMMNC), and accessory cells in the BMMNC were necessary for expression of this G-CSF-induced in vitro megakaryocytopoiesis. These results suggest that, in coordination with accessory cells, G-CSF stimulated megakaryocytopoiesis in the patient. This case provides valuable information for understanding the mechanisms of a lineage-unrestricted hematologic response to G-CSF, which is very rarely observed in MDS.

• Authors: N Yokose, K Ogata, E An, H Tamura, K Kamikubo, K Dan, T Nomura
• Journal: Annals of hematology (Ann Hematol) Vol. 70 Issue 3 Pg. 163-7 (Mar 1995) ISSN: 0939-5555 [Print] Germany
• PMID: 7536478 (Publication Type: Case Reports, Journal Article)

Chemical References

• Granulocyte Colony-Stimulating Factor

Topics

• Anemia, Refractory, with Excess of Blasts (drug therapy)
• Bone Marrow (drug effects)
• Bone Marrow Cells
• Granulocyte Colony-Stimulating Factor (therapeutic use)
• Hematopoiesis (drug effects)
• Humans
• Male
• Megakaryocytes (cytology)
• Middle Aged
• Monocytes (cytology, drug effects)