Objectives: Colony stimulating factors have been shown to accelerate recovery from severe neutropenia after intensive chemotherapy. To prove its clinical effectiveness, we conducted controlled study to administer G-CSF in acute leukemia after induction chemotherapy. Method: Forty patients with newly diagnosed and relapsed or refractory acute leukemia after remission induction chemotherapy were randomly assigned to one of two groupa (20 G- CSF treated group, 20 control grouP). Treatment with G-CSF(200 ug/m(2)/d) was started 48 hours after the end of chemotherapy and continued until the neutrophil count rose above 1,500 /mm(3). Results: Treatment with G-CSF shortened neutropenic period after chemotherapy, i.e., median duration of neutrophil counts less than 1,000/mm(3) was 21 days in control group and 12 days in G-CSF treated group. The incidence of infection was 80%in control group, 70% in G-CSF treated group, but it did not show any statistically significant difference. Microbiologically documented infection was 40% in control group, 20% in G-CSF treated group. Febrile periods and duration of antibiotic administration were decreased to 7 days and 18 days respectively. In G- CSF treated group, two Patients reported mild bone pain. There was no evidence that G-CSF could increase remission duratian and survival. Conclusion: It appears that recombinant G-CSF is safe and useful in neutropenic patients after intensive chemotherapy, accelerating neutrophil recovery and thereby reducing the incidence of documented infection and duration of antibiotic ad#ministration.
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