RECOMBINANT HUMAN GRANULOCYTE-COLONY-STIMULATING FACTOR IN CYCLIC NEUTROPENIA - USE OF A NEW 3-DAY-A-WEEK REGIMEN

Background: G-CSF has been shown to be beneficial in cyclic neutropeni a when given as a daily subcutaneous injection. We investigated the us efulness of a new three-day-a-week regimen. Methods: A ten year old bo y with cyclic neutropenia was initially treated with G-CSF 7 mu g/kg g iven on alternate days for seven months. He was then placed on the sam e dose, given three days a week. The effectiveness of these regimens w ere assessed by serial CBCs and by the frequency and duration of the s ymptoms. Results: The mean absolute neutrophil count (ANC) increased f rom 1282 before therapy to 11,718/mu l on alternate day regimen and 77 16/mu l on three-day-a-week regimen. The nadir ANC improved from 30/mu l before therapy to 546/mu l and 198/mu l on treatment. The duration and frequency of mouth sores were significantly less on therapy, and t here was an estimated cost savings of $23,826/year on three-day-a-week regimen compared to a daily regimen. Conclusion: The three-day-a-week G-CSF regimen is clinically effective and cost saving in the treatmen t of cyclic neutropenia and should be studied in a larger cohort of pa tients.