ROLE OF GRANULOCYTE-COLONY-STIMULATING FACTOR IN RELAPSED RESISTANT INTERMEDIATE AND HIGH-GRADE NON-HODGKINS-LYMPHOMA PATIENTS TREATED WITHTHE E-SHAP REGIMEN

Aims and background: The study assessed the role and potential benefit of rhG-CSF in reducing the frequency, duration and severity of neutro penia following cytotoxic chemotherapy according to the E-SHAP protoco l and, at the same time in improving the response rate. Methods: Twent y patients with resistant/relapsed intermediate or high-grade non-Hodg kin's lymphoma were treated with the E-SHAP regimen (etoposide + methy l prednisolone + high dose cytosine arabinoside and cisplatin), and in 15 of them, we administered rhG-CSF between chemotherapeutic courses. Results: The 15 patients who received G-CSF after E-SHAP were neutrop enic for a short time and experienced no febrile episodes or infective complications. In contrast, in the group (5 patients) who did not rec eive G CSF, the WBC nadir was lower and the number of days with a neut rophil count below 1.0x10(9)/L was longer, with a greater risk of infe ctious complications. Of the 15 patients, only one had a delay in chem otherapy administration, and the RDI was 95% in the 65% of patients wh o received G-CSF. Of 5 patients treated with chemotherapy alone, 4 had a delay and the RDI was over 95% in only one patient. We obtained a g ood overall response rate (70%) in the group who received G-CSF. In th e historical group of 5 non-Hodgkin lymphoma patients, we observed onl y 1 partial response and 4 had progression of disease. Conclusions: Ad ministration of G-CSF is associated with an acceleration of neutrophil recovery, indicating its potential to reduce the risk of infection. T he use of G-CSF permitted us to administer intensive chemotherapy with out delay and according to standard dosage, with an improved response rate.