Granulocyte Colony Stimulating Factor GCSF

The granulocyte colony-stimulating factor abrogates the early myelosuppressive effects of interferon119 and reverses neutropenia in some HCL patients. It does have a role in the initial treatment of actively infected HCL patients. Of four patients with HCL treated with G-CSF at 1 to 6 |ig/kg daily for 6 weeks, three had normalization of their absolute neutrophil counts in 1 to 2 weeks.119 A single patient with HCL and a history of cutaneous vasculitis developed acute neu-trophilic dermatosis (Sweet's syndrome) following the administration of G-CSF.

Thirty-five patients with HCL who received G-CSF before and after 2-CdA were compared with one hundred five historic control subjects treated with 2-CdA alone.120 The G-CSF regularly increased the absolute neutrophil count in patients with HCL and shortened the duration of severe neutropenia after 2-CdA. Nevertheless, the percentage of febrile patients, number of febrile days, and frequency of admissions for antibiotics were not statistically different in the two groups. Accordingly, the routine adjunctive use of G-CSF with 2-CdA in the treatment of HCL cannot be recommended.

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