Effects of human granulocyte colony-stimulating factor in a patient with idiopathic neutropenia

Article Abstract:

In chronic idiopathic neutropenia, the number of neutrophils, which compose an important class of white blood cells, are greatly reduced in the circulating blood. This occurs because the patient's bone marrow does not produce or release adequate numbers of the cells. The cause of this decrease in bone marrow productivity is unknown. Recently, several highly active, normally occurring growth-promoting substances have been discovered, and in some cases purified, and synthetically produced by recombinant genetics. One of these compounds is granulocyte colony-stimulating factor (G-CSF). G-CSF is a growth-promoting substance that causes an increased production of granule-containing white blood cells, including neutrophils. G-CSF causes neutrophils to proliferate and mature in both living animals and in tissue culture. A 70-year-old woman with an abscess near her anal canal was found by her doctors to have a very low neutrophil count, and thus reduced protection from infection. She was monitored for several years and no directly observable reason for her persistently low white count could be determined. She was treated with G-CSF, and her neutrophil count returned to normal, where it has remained. The patient before treatment had maintained a constant level of white blood count which did not vary, in direct contrast to a normal individual, whose white blood cell count tends to oscillate. Following treatment, the white blood cell count of this patient began showing the normal cyclical variations. These observations in a single patient suggest that G-CSF may play an important role in treating chronic idiopathic neutropenia, and that its level may be related to the causes of the condition.

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Treatment of cyclic neutropenia with granulocyte colony-stimulating factor

Article Abstract:

Cyclic neutropenia is a rare disease in which there is a reduction in circulating blood cells every 21 days. During these periods patients may experience fever, fatigue, mouth ulcers, and sometimes serious infections. Cyclic neutropenia having a 12-day cycle is found in collie dogs and has been successfully treated by transplanting healthy canine bone marrow. This procedure has not been performed on humans having cyclic neutropenia. Granulocyte colony-stimulating growth factor (G-CSF) seems to encourage blood cell production in dogs and was evaluated for its therapeutic use in humans. After five out of six patients diagnosed with cyclic neutropenia were given G-CSF, the period of neutropenia was reduced to 14 days and the number of infectious episodes decreased. G-CSF plays a significant role in blood cell production and is beneficial to patients by reducing distressing and potentially life-threatening clinical symptoms. It is suggested that this disease model be used to study the factors influencing blood cell production.

Abnormalities, Hematopoiesis

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Effects of recombinant human granulocyte colony-stimulating factor on neutropenia in patients with congenital agranulocytosis

Article Abstract:

Patients with congenital agranulocytosis, a condition in which the bone marrow fails to produce enough disease-fighting white blood cells, can now be treated with a genetically engineereed substance, recombinant granulocyte colony-stimulating factor (rhG-CSF), which makes their marrow produce more white blood cells. Nine days after patients have received the substance, the production of these cells in the marrow is greatly increased. Following this increase, the patients recovered from pre-existing infections, became infected less often and needed fewer antibiotics to recover from subsequent infections. Side effects included pain in the bone marrow and an excess of a substance in the white blood cells that deals with phosphates (leukocyte alkaline phosphates).

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