GRANULOCYTE-COLONY-STIMULATING FACTOR AND LEUKOPENIA DUE TO CYTOMEGALOVIRUS IN A RENAL-TRANSPLANT PATIENT

Leukopenia induced by cytomegalovirus (CMV) in renal transplant patien ts, and which may be aggravated by treatment with ganciclovir, is asso ciated with an increase in morbidity and mortality. We present two cas es in which granulocyte-colony stimulating factor (G-CSF) was used to treat this leukopenia. Both patients presented primary infection by CM V, confirmed clinically, serologically, and histologically. They recei ved treatment with ganciclovir at doses adjusted to their renal functi on for 20 and 14 days anti-CMV gammaglobulin 2 ml/kg/dose 7 doses in b oth and G-CSF 0.5 mug/kg/day for 6 and 3 days respectively. The increa se in leukocytes, mainly neutrophils, was marked, mainly with the firs t dose of G-CSF. Both patients recovered with no adverse effects. We c onclude that treatment with G-CSF of leukopenia coupled to CMV is effe ctive and not associated with acute rejection. In fact, an absolute or relative deficit of G-CSF may be implicated in the pathogenesis of le ukopenia.