Comparison of two strategies for the treatment of radiogenic leukopenia using granulocyte colony stimulating factor.

Abstract

PURPOSE:

Radiation-induced leukopenia can cause a delay or discontinuation of radiotherapy. This complication can be overcome with the use of granulocyte colony-stimulating factor (G-CSF). However, an uncertainty exists regarding the mode of application of G-CSF in patients treated with radiotherapy. For this reason, the efficacy of two strategies for the administration of G-CSF in irradiated patients was compared in a prospective randomized clinical study.

METHODS AND MATERIALS:

Forty-one patients who developed leukopenia (< 2.5 x 10(9) per liter) while undergoing radiotherapy were treated with G-CSF at a daily dose of 5 microg/kg. The first group received single injections of G-CSF as required (n = 21). The second group received G-CSF on at least 3 consecutive days (n = 20). An analysis was made of the changes in leukocyte counts, the number of days on which radiotherapy had to be interrupted, and the side effects of growth-factor treatment.

RESULTS:

An increase in leukocyte values in the peripheral blood was observed in all patients treated with G-CSF. In the group which received G-CSF when required, two injections (range: 1-8) were administered in most cases. In the second group, most of the patients received three injections (range: 3-9). The average duration of therapy interruptions due to leukopenia was 4.8 days (0-28) in the first therapy arm and 2.5 (0-20) in the second arm. The variance in the duration of therapy interruptions between the two groups was not significant (p = 0.2). Radiotherapy had to be terminated in two patients due to thrombocytopenia but the application of G-CSF did not seem to be a reason of decreasing platelet counts.

CONCLUSIONS:

Our results reveal that G-CSF is safe and effective in the treatment of radiation-induced leukopenia regardless of the mode of application. Because the calculated difference related to radiation treatment interruptions has no clinical relevance, both approaches examined in our study appear reasonable.

• Authors: I A Adamietz, B Rosskopf, F D Dapper, H von Lieven, H D Boettcher
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 35 Issue 1 Pg. 61-7 (Apr 01 1996) ISSN: 0360-3016 [Print] United States
• PMID: 8641928 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Recombinant Proteins
• Granulocyte Colony-Stimulating Factor

Topics

• Adult
• Aged
• Aged, 80 and over
• Female
• Granulocyte Colony-Stimulating Factor (therapeutic use)
• Humans
• Leukopenia (etiology, therapy)
• Male
• Middle Aged
• Radiotherapy (adverse effects)
• Recombinant Proteins (therapeutic use)