Abstract

Neutropenia and subsequent susceptibility to infection are the major side effects of cytotoxic chemotherapy. Although colony stimulating factors have been shown to accelerate recovery from severe neutropenia after intensive chemotherapy, their use in acute leukemia has been controversial because they stimulate leukemic colonies in vitro. To determine the safety and efficacy of recombinant human granulocyte colony-stimulating factor (rh G-CSF), we evaluated 21 periods of rh G-CSF treatment in 15 patients with acute myeloid leukemia (AML) who received induction or consolidation therapy (9 female, 6 male). rh G- CSF (5m/kg daily subcutaneously) was begun 24 hours after the end of the chemotherapy consisting of Daunorubicin (45 mg/m2 daily intravenously for 3 days) and Ara-C (100 mg/m2 by continuous infusion for 7 days) and continued until the neutrophil count rose above 1000/mm3 for two consecutive days. The historical control group consisted of 19 AML patients who received same chemotherapy regimen but without rh G- CSF. Compared with control group patients treated with rh G-CSF had a significantly faster neutrophil recovery. The number of days to granulocyte recovery above 1000/mm3 was 11+0.81 in the rh G-CSF group versus 20+1.58 days in control group (p