호중구감소증 환아에서 과립구 집락자극인자 및 과립구 대식세포 집락자극인자의 임상시도

Abstract

Background: Colony stimulating factor(CSF) has been shown to accelerate neutrophil recovery after chemotheraphy, aplastic anemia and Kostmann disease. The efficacy of G-CSF and GM-CSF in children has been evaluated in a variety of clinical settings. Method: We administered CSF(Filgrastim) in 25 neutropenic patients-in 16 patients after chemotheraphy in the treatment of acute leukemia(7 with acute myelogenous leukemia and 9 with acute lymphocytic leukemia) and in 6 patients with aplastic anemia and in 3 patients with Kostmann disease. Dosage of CSF was 5 ㎍/kg/day and continued for 7 days. Results: In the 4 patients with Kostmann disease, CSF therapy reduced the duration of fever and infection and an increase in the number of neutrophils was noted. In the 6 patients with aplastic anemia, the average absolute neutrophil count increased from 434/ μl to 1597/μl. In 2 of the 7 patients with acute myelogenous leukemia, the absolute neutrophil count increased significantly and all 9 patients with acute lymphocytic leukemia increased significantly. Conclusion: The efficacy of CSF in neutrupenia due to bone marrow suppression is different in a variety of clinical settings. We conclude that CSF is useful in the treatment of neutropenia in children. But their long term efficacy, toxicity, the optimal dose and dosing schedule to be used for each indication remains to be determined and further investigation is needed.