SHORTENED TIME TO RECOVERY FROM CHEMOTHERAPY-INDUCED NEUTROPENIA IN PEDIATRIC-PATIENTS WITH HIGH-DOSE COMBINED CYTOKINES

Granulocyte colony stimulating factor (G-CSF) and granulocyte macropha ge colony stimulating factor (GM-CSF) are cytokines which have been ex tensively administered as monotherapy to patients with a variety of he matopoietic disorders at dosages of 5 mcg/kg/day. Because their spectr um of activity is both singular and simultaneously overlapping we post ulated that combined therapy would be more advantageous than monothera py. Since 1992 we have carried out a study of G-CSF and GM-CSF as mono therapy or in combination in pediatric patients with solid tumors foll owing chemotherapy induced nadirs of 0-800 WBC/mm(3). When combined, t he cytokines were given twice per day at 2.5 or 5.0 mcg/kg. For the mo notherapy groups, either cytokine at 5 mcg/kg or 10 mcg/kg was given o nce daily The mean time to recovery from neutropenia nadir ranged from 6.6-8.2 days in patients receiving a total of 10 mcg/kg/day compared to 10.4-10.6 days in patients treated with 5 mcg/kg/day. Side effects were ephemeral eosinophilia. The dosage of 10 mcg/kg/day appears to be a better dosage for pediatric patients with a slight advantage in the combined twice a day schedule (6.6 days).