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Five patients with leukopenia and rheumatoid arthritis were treated with sodium aurothiomalate. An improvement in peripheral white blood count, neutrophil count and articular index was noted in all patients.
The clinical usefulness of Recombinant Human Granulocyte Colony Stimulating Factor (rhG-CSF, Filgrastim, GRAN) was evaluated in patients with leukopenia and neutropenia following chemotherapy for non-Hodgkin's lymphoma, lung cancer and breast cancer. During chemotherapy when patients' leukocyte count (WBC) fell below 4.0 x 10(9)/L.rhG-CSF(GRAN) at a dose of 75 micrograms/body.day was given subcutaneously 48 hours after the termination of chemotherapy. The results indicated that rhG-CSF(GRAN) could elevate nadirs of WBC and significantly shortened leukopenic period with WBC below 4.0 x 10(9)/L and expedited the recovery of WBC. rhG-CSF (GRAN)'s side effects were mild.
ACPRs of leukopenia in peripheral blood of workers exposed to benzene in small-scale industries are calculated using capture-recapture methods. The results from two figures with 6-month apart demonstrate that the ACPR in workers exposed to benzene is 36.81(29.14-44)%, significantly higher than that of control 12.71(7.20-18.22)% (P < 0.05), with a relative risk of 2.9. The prevalences of 4 cross-sectional investigations in exposure group calculated with routine method are 18.73%, 26.37%, 27.93%, and 36.76% respectively; in controls, 8.38%, 6.85%, 7.94%, and 15.00% respectively and all fall in the range of 95% CI of ACPR. It is suggested that the methods of calculating ACPR by capture-recapture methods is simple, feasible and efficient, with the results more precise than with traditional methods.
In vitro studies of polymorphs exposed to cellulose and polysulfone membranes showed severe impairment in randommobility with the cellulose membrane. In vivo studies with the two membranes showed that profound leukopenia occurred only when cellulose membrane was used. It is suggested that random mobility may have importance in the regulation of peripheral polymorph levels.
Course of the disease and some indices of immunity were studied in 100 children with Sonne's and Flexner's dysentery. Parameters of immunity in 32 children (the 1st group) were normal. 68 patients (the 2-nd group) had secondary immune deficiency and leukopenia. Recovery of immunodeficient children in use of antibiotics and prodigiosan was slowed down by 5.2 days as compared to that of children without immunodeficiency. Antibiotics used in combination with lysozyme in patients of the 1st group resulted in restoration of immunological reactivity and recovery in usual terms.
Doxorubicin is reported to cause myelosuppression, with a white blood cell count nadir occurring between day 7 and day 10. Thrombocytopenia is less severe and occurs between days 3 and 8. This report presents an early onset of leukopenia (day 5) and a severe thrombocytopenia (4000 platelets/microliter) (day 6) associated with doxorubicin administration for treatment of recurrent tonsillar squamous cell carcinoma in a dog.
The therapeutic effect of Fuzhen Compound, a Chinese herbal medicine, on leukocyte count in 59 patients with cancer of advanced stage after chemo-or radiotherapy were observed. Among 41 cases with leukopenia before treatment, leukocyte of 37 cases were normalized after treatment, the count pre-and post-treatment were (2.8 +/- 0.6) x 10(9)/L and (5.9 +/- 1.4) x 10(9)/L respectively (P < 0.01). In 18 patients with normal leukocyte count before treatment, the counts of 17 cases were still kept in normal after treatment. The time for leukcoyte recovering was 8.0 days in average, while that of 23 patients did not take Fuzhen Compound was 20.6 +/- 1.8 days. The results indicated that the Fuzhen Compound could alleviate the inhibition of chemo-or radiotherapy on hemopoietic function of bone marrow and has leukocytogenic effect.
Sixty-six chemotherapy-naive patients with non-small-cell carcinoma of the lung were given two courses of systemic chemotherapy consisting of mitomycin C, vindesine, and cisplatin. The effect of the timing of administration of grannulocyte colony-stimulating factor (G-CSF) on the incidence of neutropenic fever, the nadir leukocyte count, the duration of neutropenia ( < or = 1000/mm3), and the time needed for recovery from neutropenia was studied. Patients were assigned at random to begin receiving G-CSF (50 microns/m2, subcutaneously) either when the leukocyte count was less than or equal to 1000/mm3 (group I) or when it was between 1000/mm3 and 2000/mm3 (group II), in a crossover fashion. The nadir leukocyte count was lower in group I than in group II (859/mm3 and 1215/mm3, respectively). The duration of leukopenia (defined as a leukocyte count less than or equal to 1000/mm3) was greater in group I than in group II (1.5 days and 0.8 day, respectively), as was the time needed for recovery to a leukocyte count of 2000/mm3 (1.9 days and 1.6 days, respectively) (p < 0.05). No differences were found in the incidence of neutropenic fever (group I: 44%, group Ii: 45%), in the duration of fever (group I: 2.3 days, group II: 2.8 days), or in the duration of G-CSF use (group I: 6.3 days, group II: 6.8 days). There were no treatment-related deaths in either group. We conclude that when this type of combination chemotherapy is given for non-small-cell carcinoma of the lung, administration of G-CSF can be postponed without clinical problems until the leukocyte count is less than of equal to 1000/mm3.
Significant peripheral white blood cell depression was noted in 75% of postmastectomy patients receiving chest wall and nodal irradiation and in 50% of patients receiving only peripheral nodal irradiation. Leukopenia was documented for as long as 36 months following therapy. With the current trend to earlier institution of chemotherapy, the routine use of postoperative irradiation must be reevaluated.
Drug-induced toxic epidermal necrolysis is a disease of severe morbidity and high mortality. In the ten cases reported herein, therapeutic measures, including antibiotics, closed mechanical ventilation, maintenance of fluid and electrolyte balance, and management in special burn-care units, failed to alter a poor prognosis. The administration of corticosteroids was of no apparent benefit and may have been detrimental. Young age seemed to have a favorable influence on survival. There developed a pattern of leukopenia due to severe granulocytopenia that proved to be of prognostic importance. Persistence of the granulocytopenia portended a fatal outcome, whereas recovery of the granulocyte count to normal indicated, overall, a more favorable trend. The cause of the granulocytopenia could not be determined.
BACKGROUND: High-dose chemotherapy with autologous stem cell transplantation is the standard treatment of eligible patients with multiple myeloma. However, this treatment is associated with a substantial risk of infectious complications during leukopenia. The aim of our pilot study was to determine the residual leukocyte subsets during severe cytopenia after high-dose melphalan and to correlate this with the occurrence of neutropenic fever. METHODS: Residual leukocyte subsets in the peripheral blood on days 4-7 following autologous stem cell transplantation were analyzed by three-color flow cytometry in 20 patients with multiple myeloma. In addition, we determined the number of T cells that were transfused with the autografts. RESULTS: Absolute numbers of lymphocytes (mean 25/microL) and monocytes (mean 4/microL) were strongly reduced but rather constant during the period of severe neutropenia. Neutrophil engraftment and duration of neutropenia were very similar in patients with and without neutropenic fever. Low absolute lymphocyte counts and absolute CD4+ T-cell counts on days 4-7 after stem cell transplantation correlated with neutropenic fever. Furthermore, T-cell numbers in the autologous stem cell grafts that the patients received were significantly lower in patients with neutropenic fever. DISCUSSION: These observations suggest that the number of T cells, and in particular CD4+ T cells, in the blood during severe cytopenia is playing a role in defense of infection. T-cell numbers in the graft could provide a predictive factor for the risk of infection in the post-transplant period. However, this needs to be confirmed in a larger study.
Results are submitted of investigations designed to study parameters characterizing the peripheral blood neutrophil functional activity in leukopenias accompanying the course of rheumatism. Neutrophils were proved to be defective, their disturbed functional activity being manifested by the decrement of their ability to restore the NBT-test. There has been noted an inadequate augmentation of the metabolic activity following neutrophil stimulation as compared to results in healthy subjects. Of practical significance in the above investigations is screening of patients presenting with low values for the functional reserve of neutrophils as a threat to the early prediction of the course of pyo-inflammatory complications. It is suggested that a spontaneous NBT-test be used in the differential diagnosis of bacterial and non-bacterial complications while a stimulated NBT-test is believed to be helpful in identifying neutrophil dysfunction when results of a spontaneous NBT-test are at variance with clinical findings.
Since 1997, we have used docetaxel and paclitaxel as the second-line and third-line chemotherapies against anthracycline-resistant metastatic breast cancer. However, these taxane compounds induced neutropenia and leukopenia, which may be reversed by G-CSF (Nartograstim). We thus examined the therapeutic efficacy of nartograstim for time-course changes in neutrophil and leukocyte counts in these patients. No difference was observed in neutrophil or leukocyte count whether the patient was treated with docetaxel or paclitaxel. Neutrophil and leukocyte counts reached a nadir on days 7 to 8 after administration. With a 5-6 day administration of nartograstim, neutrophil or leukocyte counts recovered by the second or third day after the nadir, indicating that the chemotherapy was given safely with nartograstim. In these same patients receiving a given treatment cycle, the number of days until reaching the nadir were almost identical for neutrophils and leukocytes; however, the duration of the nadir and the time to count recovery was significantly longer for neutrophils than for leukocytes. In the clinical setting, the parameter "leukocyte count" has been occasionally used for evaluation of the severity of myelosuppression, because the data is more readily available. However, at least during the nadir, the "neutrophil count" should be used as the parameter of choice.
To examine the effect of Lishengsu (rhG-CSF) on the recovery of leukopenia and control of infections after chemotherapy, twenty tumor patients were observed. When blood WBC decreased to less than 2.5 x 10(9)/L and ANC less than 1.5 x 10(9)/L after chemotherapy, Lishengsu was administered in a dosage of 150 micro g/day for 5 days or until WBC and ANC recovered to normal level. The changes of hemogram, body temprature, the signs of oral mucous membrane and lung were examined. The recovery of WBC and ANC in the Lishengsu group was much faster than that in the control group. The difference between the two groups was statistically significant (P < 0.01). The duration of fever was shorter and the healing of oral ulcers was faster in Lishengsu group than that in the control group (P < 0.05). The results indicated that Lishengsu in a low dosage and a short administration period could enhance the recovery of WBC and ANC efficiently, shorten the duration of fever, quicken the recovery process of oral ulcers and reduce the needs for supporting treatment in tumor patients after chemotherapy.
Thrombocytopenia, a fairly uncommon side effect of phenothiazine treatment, usually appears in the presence of a concommitant leukopenia. The authors report 1 patient in whom the illness appeared in the presence of a long known Beta thalassemia but without evidence of alteration in myeloid or lymphoid series. Platelet changes were seen in the presence of a butyrophenone and an aliphatic phenothiazine. A piperazine derivative was used without difficulty.
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