To evaluate the clinical effect by administration of recombinant human granulocyte-stimulating factor (rhG-CS) post chemotherapy in non-Hodgkin malignant lymphoma (NHL), fifteen patients with NHL were subjected to this study. In patients with CHOP, VEPA or M-FEPA combination chemotherapy, administration of rhG-CSF ameliorated the decrease in absolute neutrophil count after the cytotoxic chemotherapy and was effective for reducing infection complications associated with neutropenia. These clinical effects were observed in ProMACE/CytaBOM regimen as the third generation chemotherapy. Furthermore, administration of rhG-CSF post cytotoxic chemotherapy increased peripheral hematopoietic progenitor cells, thus suggesting promising therapeutic potential for harvest for autografting.
No adverse effects were observed except for one patient complaining of a bone pain of mild degree. rhG-CSF showed no effect on platelet glycoprotein expression and aggregation.
Recently, it has been reported that blood neutrophils may synthesize mRNA and proteins important in inflamation including variuos cytokines such as interleukin-1 (IL-1), interferone-alpha (IFN-α) and tumor necrosis factor-α (TNF-α). Administration of rhG-CSF provided no fluctuation of serum IFN-α level except for one case with peripheral T-cell lymphoma expressing IFN-transcript in peripheral neutrophils prior G-CSF treatment. Slight elevations of serum TNF-α level associated with rhG-CSF treatment in two patient, although the present study showed no evidence that their neutrophilsproduced TNF-α. These results suggested that further study will be needed to clarify in vivo significance of G-CSF in the cytokine network system.
Finally, we studied on anti-tumor effect of administration of rhG-CSF in CDF1 mice inoculated with L5178Y-ML25 lymphoma cells. Administration of rhG-CSF inhibited the liver metastasis and prolonged the overall survival, thus suggesting the hyposis that the use of rhG-CSF in some patients with NHL might control the disease with activation of netrophils.