Stimulation of granulopoiesis by high-dose recombinant human granulocyte
colony-stimulating factor in children with aplastic anemia and very severe
neutropenia
S Kojima and T Matsuyama
Division of Hematology and Oncology, Children's Medical Center, Japanese
Red Cross Nagoya First Hospital, Japan.
We investigated the efficacy and safety of high-dose recombinant human
granulocyte colony-stimulating factor (rhG-CSF) in treating 10 children
with severe aplastic anemia and fewer than 0.05 x 10(9)/L neutrophils.
Doses of rhG-CSF ranging from 400 to 2,000 micrograms/m2/d were
administered as a 30-minute intravenous infusion daily for 4 weeks. In 6 of
the 10 children, treatment increased the neutrophil count by 10- fold to
greater than 60-fold (range, 0.21 to 1.8 x 10(9)/L). Bacterial or fungal
infections that were present at study entry resolved in all 6 responders,
who are still alive with a median survival of more than 27 months (range,
15 to 54 months) since the initiation of treatment. Three of 4
nonresponders died of infection, whereas 1 nonresponder received a bone
marrow transplant and is alive. No serious toxicity was attributable to
rhG-CSF. It was well tolerated at doses up to 2,000 micrograms/m2/d and
effectively stimulated granulopoiesis. This agent thus offers promise as
adjuvant treatment for severe infections in children with aplastic anemia
and very severe neutropenia.
Volume 83,
Issue 6,
pp. 1474-1478,
03/15/1994
Copyright © 1994 by The American Society of Hematology
