Hellmich B, Schnabel A, Gross W L
Medizinische Universität zu Lübeck, Germany.
Arthritis Rheum. 1999 Aug;42(8):1752-6. doi: 10.1002/1529-0131(199908)42:8<1752::AID-ANR26>3.0.CO;2-6.
To examine the efficacy and safety of recombinant human granulocyte colony-stimulating factor (rHuG-CSF) in the treatment of cyclophosphamide (CYC)-induced severe neutropenia (<1,000 neutrophils/microl) in patients with generalized Wegener's granulomatosis (WG).
Six WG patients with severe neutropenia due to CYC treatment (group A) were given short-term dosages of rHuG-CSF. Treatment response in these 6 patients was compared with that in 6 WG patients who were matched for age, sex, disease status, and prior treatment and who received supportive treatment only (group B).
The duration of severe neutropenia was significantly shorter in group A patients (4.0+/-0.8 days) than in group B patients (9.0+/-1.3 days; P = 0.03). This was accompanied by fewer bacterial infections (2 versus 4) and fewer nonbacterial infections (0 versus 3) in group A compared with group B patients. Treatment with rHuG-CSF was well tolerated and, notably, no disease flare occurred during treatment and up to 4-6 months after rHuG-CSF administration.
Short-term, low-dose rHuG-CSF treatment can substantially shorten the duration of CYC-induced neutropenia and appears to confer significant clinical benefit. Such treatment, aimed at raising the neutrophil count above 1,000/microl, does not appear to carry a high risk of inducing a flare of the vasculitis.
研究重组人粒细胞集落刺激因子（rHuG-CSF）治疗环磷酰胺（CYC）诱导的广泛性韦格纳肉芽肿（WG）患者严重中性粒细胞减少症（中性粒细胞<1000/微升）的疗效和安全性。
6例因CYC治疗导致严重中性粒细胞减少的WG患者（A组）接受短期剂量的rHuG-CSF治疗。将这6例患者的治疗反应与6例年龄、性别、疾病状态和既往治疗相匹配且仅接受支持治疗的WG患者（B组）进行比较。
A组患者严重中性粒细胞减少的持续时间（4.0±0.8天）明显短于B组患者（9.0±1.3天；P = 0.03）。与B组患者相比，A组患者的细菌感染（2次对4次）和非细菌感染（0次对3次）更少。rHuG-CSF治疗耐受性良好，值得注意的是，在治疗期间以及rHuG-CSF给药后长达4至6个月内均未出现疾病复发。
短期、低剂量的rHuG-CSF治疗可显著缩短CYC诱导的中性粒细胞减少症的持续时间，且似乎具有显著的临床益处。这种旨在将中性粒细胞计数提高到1,000/微升以上的治疗方法似乎不会带来引发血管炎复发的高风险。
