Abstract
We examined neutrophil functions in seven elderly patients with non-Hodgkin's lymphoma before and during treatment with granulocyte colony-stimulating factor (G-CSF) at the neutropenic stage after combination chemotherapy. Subcutaneous injection of 75μg/d of G-CSF produced by E. coli was started when the neutrophil count decreased less than 1, 500/μl, and continued until the neutrophil count increased to about 10, 000/μl. The phagocytic activity of neutrophils from the elderly on day 3 of G-CSF treatment was markedly enhanced; 1, 129.9±403ps/100PMNs, which was 185.7 ±31.4% (p<0.001) as compared with that before G-CSF treatment. The neutrophil alkaline phosphatase (NAP) activity was also enhanced on day 3; 398.3±48 score, which was 135.2±5.1% (p<0.001) as compared with that before G-CSF treatment. Two patients developed interstitial pneumonitis during or shortly after the treatment with G-CSF. Interstitial pneumonitis suddenly developed when their neutrophil count was increased, and the phagocytic activity and NAP activity recovered. The phagocytic activity of neutrophils from them was enhanced to 1, 090±26ps/100PMNs and 772ps/100PMNs during the treatment with G-CSF, as compared with that before G-CSF treatment of 644±29ps/100PMNs and 465±69ps/100PMNs, respectively. The NAP activity was also enhanced to 372 from 264. One patient suffered from transient pulmonary dysfunction during the treatment with G-CSF. His neutrophil count was more than 13, 000/μl, and the phagocytic activity enhanced to 949±105ps/100PMNs. Dyspnea with suppressed PaO2 recovered reversibly after cessation of G-CSF. Pulmonary function should be carefully assessed in the elderly.
