Abstract
A 70-year-old man was admitted to our hospital with pancytopenia. He was diagnosed as having MDS(RA), and therapy with subcutaneous S-CSF(100μg/day) was started. His leukocyte count increased from 800/μl to 1, 400/μl in two weeks. The dose of G-CSF was raised to 200μg/day in the third week, and leukocytes increased to 2, 00/μl. At the fifth week, intravenous EPO(6, 000U×3 times/week) was added. His leukocyte count increased to 4, 000/μl. EPO therapy was raised to 12, 000U×3 times/week at the eighth week, his leukocyte count remained at the same level. G-CSF and EPO was stopped at the eleventh week, and leukocytes decreased to the same level as before administration. Throughout the course, his platelet count and reticulocyte count did not change. G-CSF and EPO are known as the stimulators of granuriod and erythroid progenitor, respectively. However, in this case, combination therapy with G-CSF and EPO induced marked increase of granulocytes only. This was an interesting case in relation to the roles of these cytokines in the hematopoietic system.
