PRODUCTION OF GRANULOCYTE-COLONY-STIMULATING FACTOR, GRANULOCYTE-MACROPHAGE COLONY-STIMULATING FACTOR, AND TUMOR-NECROSIS-FACTOR-ALPHA DURING REMISSION AND INFECTIONS IN PATIENTS WITH ACUTE-LEUKEMIA

We measured circulating serum levels of granulocyte colony stimulating factor (G-CSF), granulocyte macrophage colony stimulating comparable to the levels of these factors in 12 children with acute febrile infec tions without malignancy or hematological disorders and 15 age matched healthy controls. There were significantly elevated levels of G-CSF, GM-CSF and TNF alpha, in 12 children with infections without leukemia, as compared with controls. Also in 18 leukemic children with infectio ns serum G-CSF and TNF alpha levels were significantly higher than tho se in the leukemic children without infection and healthy controls, wh ereas no significant difference was noted in the GM-CSF levels in thes e groups. Although elevation in TNF alpha levels in response to infect ions were similar in the children with and without leukemia, in the G- CSF levels lower elevation was noted in the leukemic children with inf ections as compared to the children with infections without leukemia. Despite leukopenia enhanced the production of G-CSF, even in leukopeni c children with leukemia and infections, serum G-CSF levels were still lower than those for the children with infections without leukemia. W e concluded that, the production of G-CSF and GM-CSF as a response to infection was deficient in the patients with acute leukemia in remissi on, probably due to the maintenance and reinforcement chemotherapy. Th erefore, the use of recombinant G-CSF may be recommended in the infect ions of these patients.