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

Abstract

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. Open label, phase I/II study of G-CSF, given by daily subcutaneous injection for up to 7 weeks. Outpatient oncology clinic of a university medical center. 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. Granulocyte colony-stimulating factor was given by daily subcutaneous injection. Each patient began therapy with 1 .mu.g/kg body weight .cntdot. d; after 1 week the dose was increased to 3 .mu.g/kg .cntdot. d, and 1 week later to 6 .mu.g/kg .cntdot. d. Therapy was continued for 5 to 6 weeks. Patients were taught self-injection, and administered treatment at home. In three patients, an increase in absolute neutrophil counts from less than 0.9 .times. 109/L to greater than 4.0 .times. 109/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 .mu.g/kg .cntdot. d of G-CSF, and drug therapy was discontinued. 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.