[Granulocyte colony-stimulating factor in neutropenia secondary to lymphoid bone marrow infiltration]

In patients with low-grade lymphoid malignancy, severe neutropenia due to massive bone marrow infiltration of lymphocytes increases the risk of infection, especially after myelosuppressive chemotherapy. Three patients (two with chronic lymphocytic leukemia and one with follicular lymphoma) with massive bone marrow infiltration and neutropenia not caused by short-term effects of chemotherapy, were treated with G-CSF for five two-week periods, to find out if the neutropenia was reversible. All three patients initially responded to G-CSF with an increase of neutrophil counts into the normal range or above. In one patient, G-CSF administered after a subsequent course of myelosuppressive chemotherapy apparently prevented severe chemotherapy-induced neutropenia. Retreatment of a previous responder in a later, preterminal stage of the disease produced very little response in terms of neutrophil counts. G-CSF can increase peripheral blood neutrophil counts to normal levels in patients with severe neutropenia induced by lymphoid bone marrow infiltration.