Korean J Hematol 1993; 28(1):
Published online March 31, 1993
© The Korean Society of Hematology
급성골수성백혈병 환자의 화학요법에서 Granulocyte Colony-Stimulating Factor(Filgrastim)의 효과
정병천, 곽동석, 최정일, 임종우, 이규보
경북대학교병원 혈액내과
The Effect of Granulocyte Colony-Stimulating Factor in Chemotherapy of Acute Myelogenous Leukemia
Background: An increased dosage of chemotherapy and a trial of bone marrow transplantation in acute leukemia result in severe marrow suppression which may cause
fatal infections. Efficacy of recombinant human granulocyte colony-stimulating factor(rhG-CSF) has been evaluated in chemotherapy of acute myelogenous leukemia.
MethodsWe administered rhG-CSF (filgrastim) for 30 neutropenic patients caused by remission induction chemotherapy in the treatment of acute myelogenous
leukemia(AML) and assessed its hematologic responses and toxicities, which were compared to 30 historical control group. Dosage of G-CSF was 200 μg/m2
initially and was tappered to 50-100μg/m2with monitoring of leukocyte counts in order to avoid overstimulation of leukocyte production. We checked the
peripheral blood counts serially and observed the clinical courses, and assessed the usefulness of G-CSF.
Results: Recovery period of granulocyte counts over 1,000/μl and 1,500/μl was significantly shorter in G-CSF group than control(P<0.05, 11d vs 16d and 15d vs 22d).
But platelet and blast counts were not significantly increased. There was no remarkable difference in the incidence of toxicities such as myalgia, bone pain and chilling between two groups. Also we had no case of hypotension, pleuritis, edema and venous thrombosis after injection of the G-CSF. The numbers of febrile episodes during those periods were not different berween two groups, but bacteriologically documented cases were significantly lesser in G-CSF group than conrol(P<0.05, 6 vs 9).
Conclusion: We can conclude that G-CSF (filgrastim) is very useful in overcoming the bone marrow suppression during remission induction therapy of AML by facilitating
the leukocyte recovery and the usefulness of G-CSF is 80%. And also it could be expected that we will be able to improve remission rate of acute leukemia by more
intensive chemotherapeutic regimens by use of G-CSF without significant side effects.
Keywords Acute Myelogenous Leukemia; Granulocyte Colony-Stimulating Factor (G-CSF); Leukopenia;
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Korean J Hematol 1993; 28(1): 21-30
Published online March 31, 1993
Copyright © The Korean Society of Hematology.
급성골수성백혈병 환자의 화학요법에서 Granulocyte Colony-Stimulating Factor(Filgrastim)의 효과
정병천, 곽동석, 최정일, 임종우, 이규보
경북대학교병원 혈액내과
The Effect of Granulocyte Colony-Stimulating Factor in Chemotherapy of Acute Myelogenous Leukemia
Byung Chun Chung, Dong Suk Kwok, Jung Il Choi, Jong Woo Lim, Kyu Bo Lee
Division of Hematology, Internal Medicine, Kyungpook National University, Taegu, Korea
Abstract
Background: An increased dosage of chemotherapy and a trial of bone marrow transplantation in acute leukemia result in severe marrow suppression which may cause
fatal infections. Efficacy of recombinant human granulocyte colony-stimulating factor(rhG-CSF) has been evaluated in chemotherapy of acute myelogenous leukemia.
MethodsWe administered rhG-CSF (filgrastim) for 30 neutropenic patients caused by remission induction chemotherapy in the treatment of acute myelogenous
leukemia(AML) and assessed its hematologic responses and toxicities, which were compared to 30 historical control group. Dosage of G-CSF was 200 μg/m2
initially and was tappered to 50-100μg/m2with monitoring of leukocyte counts in order to avoid overstimulation of leukocyte production. We checked the
peripheral blood counts serially and observed the clinical courses, and assessed the usefulness of G-CSF.
Results: Recovery period of granulocyte counts over 1,000/μl and 1,500/μl was significantly shorter in G-CSF group than control(P<0.05, 11d vs 16d and 15d vs 22d).
But platelet and blast counts were not significantly increased. There was no remarkable difference in the incidence of toxicities such as myalgia, bone pain and chilling between two groups. Also we had no case of hypotension, pleuritis, edema and venous thrombosis after injection of the G-CSF. The numbers of febrile episodes during those periods were not different berween two groups, but bacteriologically documented cases were significantly lesser in G-CSF group than conrol(P<0.05, 6 vs 9).
Conclusion: We can conclude that G-CSF (filgrastim) is very useful in overcoming the bone marrow suppression during remission induction therapy of AML by facilitating
the leukocyte recovery and the usefulness of G-CSF is 80%. And also it could be expected that we will be able to improve remission rate of acute leukemia by more
intensive chemotherapeutic regimens by use of G-CSF without significant side effects.
Keywords: Acute Myelogenous Leukemia, Granulocyte Colony-Stimulating Factor (G-CSF), Leukopenia,
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