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Cytokine profile during high‐dose rhG‐CSF therapy in severe congenital neutropenia

The effect of recombinant human granulocyte colony‐stimulating factor (rhG‐CSF) on cytokine profile was evaluated in a case of severe congenital neutropenia. The plasma levels of cytokines were measured before and during rhG‐CSF therapy. These included G‐CSF, granulocyte‐macrophage colony‐stimulating factor (GM‐CSF), interleukin‐1α, in‐terleukin‐1 β, interleukin‐2 (IL‐2), interleukin‐3 (IL‐3), interleukin‐4, interleukin‐6 (IL‐6), and tumor necrosis factor‐α. Soluble Interleukin‐2 receptor (sIL‐2R) was measured serially during rhG‐CSF therapy. Lymphocyte subpopulations Including CD2, CD3, CD4, CD8, CD19, CD20, and CD25 were also measured, rhG‐CSF was administered once daily as a 30‐min infusion. The patient was treated with Increasing dose levels of 100,200,400, 800, and 1,600 μg/m2/day. The level of endogenous G‐CSF was elevated to 334 pg/ml before treatment and GM‐CSF, IL‐2, IL‐3, and IL‐6 were slightly elevated. Clinically, he showed a moderate response to a high dose of rhG‐CSF (1,600 μg/m2/day). Plasma levels of G‐CSF markedly Increased during therapy but plasma levels of other cytokines did not show significant changes during therapy and iymphocyte subpopulations did not significantly change. A drastic Increase in siL‐2R expression was observed after rhG‐CSF infusion and an Increase in siL‐2R expression occurred even before a major increase in granulocyte counts. These results showed that a high dose rhG‐CSF therapy may influence the cytokine network as judged by the increased slL‐2R expression. © 1994 Wiley‐Liss, Inc.