Abstract:

Objective To explore efficacy and mechanism of recombinant human granulocyte-colony stimulating factor (rhG-CSF) in treatment of different leukopenia. Methods A total of 50 patients were divided into 4 groups: aplastic anemia (AA) group (n=10), myelodysplastic syndromes (MDS) group (n=10), drug-induced leukopenia group (n=20) (subdivided into hyperplasia group and hypoplasia group by the degree of cellularity) and iron deficiency anemia group (control group, n=10). The concentrations of G-CSF of peripheral blood were measured by ELISA method. The ratio of CD34⁺ cells and G-CSFR expression in blood marrow mononuclear cells (BMMNC) were measured by flow cytometry. Granulocyte colony-forming units (CFU-G) of MNC were cultured. Clinical efficacy of rhG-CSF to all patients were determined. Results The concentrations of G-CSF were higher in AA and druginduced leukopenia groups than those of MDS and control groups (P<0.05). Expressions of G-CSFR in AA group were lower than those in other groups (P<0.05). There were no significant differences between MDS group and drug-induced leukopenia and control groups (P>0.05). Expressions of G-CSFR were lower in hypoplasia group than those in hyperplasia and control groups (P<0.05). There was no significant difference between hyperplasia group and control group (P>0.05). The ratio of CD34⁺ cells was lower in AA group than that of other groups (P<0.05), without significant differences between the others groups (P>0.05). Concentrations of CFU-G were lower in AA and MDS groups than those in drug-induced leukopenia and control groups (P<0.05). There were no significant differences between AA group and MDS group, and between drug-induced leukopenia group and control group (P>0.05). The efficacy of rhG-CSF was superior in drug-induced leukopenia group than in MDS group, and superior in MDS group than in AA group (P<0.05). Conclusion The efficacy of rhG-CSF is related to expression ratio of G-CSFR, ratio of CD34⁺ cells, and response of stem/progenitor cells to G-CSF and endogenous concentration of G-CSF.

Key words: leukopenia, granulocyte-colony stimulating factor, bone marrow mononuclear cell, efficacy, mechanism