Successful treatment of T‐γ lymphoproliferative disease with human‐recombinant granulocyte colony stimulating factor

Abstract

A trial of recombinant human granulocyte colony-stimulating factor (rhG-CSF) was attempted in a male with agranulocytosis, infection, and T-gamma lymphoproliferative disease (T-gamma-LPD). During five days of rhG-CSF (960 micrograms/day), the absolute neutrophil count (ANC) increased from 0.0 to 4.5 K/microliters. There were no changes in eosinophil or lymphocyte counts. In addition, there was no toxicity. Bone marrow cytotoxic/suppressor cells (CD57+/CD8+) were elevated (21.9%) before and decreased to 10.6% (normal less than 12%) following rhG-CSF. By contrast, there was no change in activated T cells (CD3+DR+) or T cell gene rearrangements. These findings suggest rhG-CSF can improve granulopoiesis in T-gamma-LPD, possibly by altering T-cell mediated marrow suppression.

Neutropenia Associated With T-Cell Large Granular Lymphocyte Leukemia: Long-Term Response to Cyclosporine Therapy Despite Persistence of Abnormal Cells

“…1 Therapy with corticosteroids and cytotoxic agents is usually ineffective, [3][4][5] splenectomy does not generally produce sustained increases in neutrophil counts, 6 and colonystimulating factor (CSF) therapy has not yielded consistent results. [7][8][9][10] Weekly oral low-dose methotrexate was reported to be effective in reversing neutropenia in 6 of 10 patients; LGL counts normalized in 5 of the 6, and abnormal clones identified by T-cell receptor (TCR) gene rearrangements disappeared in 3. 11 A response of T-LGL leukemia with severe neutropenia to 2-chlorodeoxyadenosine has also been reported.…”