COMBINATION THERAPY WITH RECOMBINANT HUMAN GRANULOCYTE-COLONY-STIMULATING FACTOR AND ERYTHROPOIETIN IN APLASTIC-ANEMIA

Recombinant human granulocyte colony-stimulating factor (rhG-CSF) and erythropoietin (rhEPO) were used to treat patients with aplastic anemi a (AA). In terms of effects on erythrocyte recovery, the combined use of rhG- CSF and rhEPO showed a favorable response in 6 of 14 (42.9%) p atients with moderate AA following 10 weeks treatment and in 3 of 14 ( 21.4%) patients thereafter. However, the response was poor in patients with severe AA (3/13). A favorable response in severe AA was observed in 1 of 13 (7.7%) patients following 10 weeks treatment and in 2 of 1 3(15.4%) patients thereafter. The overall effect on erythrocytes was o bserved in 44.4% patients. A dose of 400 mu g/m(2) G-CSF was sufficien t to cause an increase in neutrophil count and 100 IU/kg rhEPO appeare d to be sufficient to cause an increase in erythrocyte count. In 6 of 27 (22.2%) patients, a trilineage response was observed. Interestingly , a delayed and long-lasting effect was obtained in 5 of 27 (18.5%) pa tients. These results suggest that rhG-CSF can synergize with rhEPO in erythrocyte response, especially in patients with moderate AA. (C) 19 95 Wiley-Liss, Inc.