Document Detail

Responsiveness to G-CSF before leukopenia predicts defense to infection in high-dose chemotherapy recipients.
MedLine Citation:
PMID:  15205265     Owner:  NLM     Status:  MEDLINE    
An active assessment of the host capacity to prevent infection during myelosuppression should be beneficial in patients receiving high-dose chemotherapy. A single dose of granulocyte colony-stimulating factor (G-CSF) (5 microg/kg) was given to 57 patients with multiple myeloma early after the completion of 85 high-dose chemotherapy (melphalan 200 mg/m2) courses. This provoked a highly variable white blood cell (WBC) peak after 12 to 14 hours. The median WBC count was 21,000/microL (range, 6400-60,600/microL) after a first high-dose therapy (n = 50) and 13,500/microL (range, 4700-24,800/microL) after a second high-dose therapy (n = 35). The responsiveness to single G-CSF was associated with the risk of infection during subsequent cytopenia (P =.003). This association was significant after adjustment for neutropenia duration. Notably, the result of testing G-CSF responsiveness was opportunely available before the onset of leukopenia, and G-CSF responsiveness was more informative than neutropenia duration regarding the risk of infection. Furthermore, there was an association between the responsiveness to G-CSF and stem cell engraftment (P <.005), which remained significant after adjustment for the number of transplanted CD34+ cells. Our results show for the first time that G-CSF potentially could be used for an early in vivo assessment of defense to infection in recipients of high-dose chemotherapy.
Christian Straka; Fuat Oduncu; Axel Hinke; Hermann Einsele; Evi Drexler; Brigitte Schnabel; Lubomir Arseniev; Jochem Walther; August König; Bertold Emmerich
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Publication Detail:
Type:  Journal Article     Date:  2004-06-17
Journal Detail:
Title:  Blood     Volume:  104     ISSN:  0006-4971     ISO Abbreviation:  Blood     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-09-20     Completed Date:  2004-11-04     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7603509     Medline TA:  Blood     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1989-94     Citation Subset:  AIM; IM    
Medizinische Klinik-Innenstadt, Klinikum der Universität München, München, Germany.
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MeSH Terms
Antigens, CD34 / chemistry
Antineoplastic Agents / adverse effects*
Blood Transfusion
Clinical Trials as Topic
Granulocyte Colony-Stimulating Factor / therapeutic use*
Hematopoietic Stem Cells / cytology
Leukocyte Count
Leukocytes / cytology,  drug effects
Leukopenia / prevention & control*
Middle Aged
Multiple Myeloma / drug therapy*
Neoplasms / drug therapy*
Stem Cells / cytology
Time Factors
Reg. No./Substance:
0/Antigens, CD34; 0/Antineoplastic Agents; 143011-72-7/Granulocyte Colony-Stimulating Factor

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