GRANULOCYTE FUNCTION OF PATIENTS ON ANTI-CANCER CHEMOTHERAPY

Abstract

Granulocyte function of patients on anti-cancer chemotherapy was investigated. Five bladder cancer patients, who had undergone M-VAC neo-adjuvant, chemotherapy were select for this study. Their tumor stage was T3M0N0 and peripheral blood granulocyte and platelet counts were more than 1500/mm³ and 10×10³/mm⁴, respectively, before starting chemotherapy regardless of the course Flow-cytometric analyses were utilized to measure the function of phagocytosis and the ability to produce superoxide (bactericidal function) of granulocytes. During the course peripheral blood count, granulocyte function, urinalysis and blood chemistry were checked every other day and urine and blood culture were done once a week. Although the first couse of M-VAC was completed without using rhG-CSF, the second course of M-VAC administration required rhG-CSF when the number of peripheral granulocytes was below 1000/mm³.
The function of phagocytosis decreased from the onset of the first course of M-VAC until the nadir of granulocyte number, then recovered close the prechemotherapy level by the time when the chemotherapy was completed with the increase in the number of granulocyte but remained relatively low until starting the second course. The function deteriorated more rapidly with the second course than with the first course, but recovered rapidly after administration of rhG-CSF and was significantly higher when the nadir of granulocytes was noted with the first course of M-VAC than with the second course. As for the function of superoxide production, it decreased gradually until the nadir of granulocyte during the first course and then continued to recover toward starting the second course but failed to return to the prechemotherapy level. With the second course it decreased as was noted with the first course but after administration of rhG-CSF recovered rapidly and became higher than it was when the nadir was noted with the first couse.
This is the first report describing the change of granulocyte function (phagocytosis and superoxide production) during M-VAC chemotherapy and comparing them as they were with the first course (without rhG-CSF) with those with the second course (with rhG-CSF).
The above results suggested that the initiation of rhG-CSF to patients on intensive anti-cancer chemotherapy could be withheld until their peripheral blood granulocyte concentration became below 1000/mm³ in order to preserve their appropriate granulocyte function.