Therapy for Neutropenia in Hairy Cell Leukemia with Recombinant Human Granulocyte Colony-Stimulating Factor

  1. John A. Glaspy, MD;
  2. Gayle C. Baldwin, PhD;
  3. Paul A. Robertson, MD;
  4. Lawrence Souza, PhD;
  5. Martha Vincent, PhD;
  6. Janice Ambersley, RN; and
  7. David W. Golde, MD

    Abstract

    Study Objective: To determine whether recombinant human granulocyte colony-stimulating factor (G-CSF) is effective in increasing neutrophil counts in patients with hairy cell leukemia and neutropenia.

    Design: Open label, phase I/II study of G-CSF, given by daily subcutaneous injection for up to 7 weeks.

    Setting: Outpatient oncology clinic of a university medical center.

    Patients: A consecutive sample of four patients with hairy cell leukemia complicated by severe neutropenia. Three patients completed the study; one patient was removed after 2 weeks of therapy.

    Interventions: Granulocyte colony-stimulating factor was given by daily subcutaneous injection. Each patient began therapy with 1 µg/kg body weight ·d; after 1 week the dose was increased to 3 µg/kg ·d, and 1 week later to 6 µg/ kg ·d. Therapy was continued for 5 to 6 weeks. Patients were taught self-injection, and administered treatment at home.

    Measurements and main results: In three patients, an increase in absolute neutrophil counts from less than 0.9 X 10/L to greater than 4.0 X 10/L was noted within 2 weeks of beginning G-CSF therapy. In two patients, infections resolved during therapy. One patient developed acute neutrophilic dermatosis (the Sweet syndrome) while receiving 3 µg/kg ·d of G-CSF, and drug therapy was discontinued.

    Conclusions: Granulocyte colony-stimulating factor may increase neutrophil counts within 2 weeks in patients with hairy cell leukemia and neutropenia. This therapy may be a useful adjunct to definitive treatment of hairy cell leukemia with interferon or pentostatin.

    Article and Author Information

    • From the University of California, Los Angeles School of Medicine, Los Angeles, California. For current author addresses, see end of text.

    • Grant support: Supported in part by grants CA 32737 and CA 30388 from the National Institutes of Health, State of California University-wide Task Force on AIDS, and by a contract from Amgen Inc., Thousand Oaks, California.

    • Requests for Reprints: John A. Glaspy, MD, Room 42-121 CHS, UCLA School of Medicine, 10833 Le Conte Avenue, Los Angeles, California 90024-1678.

    • Current Author Addresses: Drs. Glaspy, Baldwin, and Ms. Ambersley: Room 42-121, UCLA School of Medicine, 10833 Le Conte Avenue, Los Angeles, CA 90024-1678,

    • Dr. Robertson: Room 42-158, UCLA School of Medicine, 10833 Le Conte Avenue, Los Angeles, CA 90024-1678.

    • Drs. Souza and Vincent: 1900 Oak Terrace Lane, Thousand Oaks, CA 91320.

    • Dr. Golde: Room 37-068 CHS, UCLA School of Medicine, 10833 Le Conte Avenue, Los Angeles, CA 90024-1678.

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    1. Ann Intern Med November 15, 1988 vol. 109 no. 10 789-795
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