HEMATOLOGICAL PARAMETERS AND LYMPHOCYTE SUB-TYPES WITH G-CSF, HIGH-DOSE METHYLPREDNISOLONE OR COMBINATION TREATMENTS IN CHILDREN WITH CHEMOTHERAPY-INDUCED NEUTROPENIA 128

Several treatments have been used in order to overcome chemotherapy-induced neutropenia that may cause increased morbidity and mortality in cancer patients. We aimed to determine the effect of different approaches for the treatment of neutropenia on hematological parameters and lymphocyte subtypes. Twenty-eight consecutive patients with absolute polymorphonuclear leukocyte(PNL) counts less than 500/mm³ while receiving maintenance of St. Jude Total XI treatment were enrolled in the study. The hematological parameters observed were hemoglobin (Hb), red blood cell (RBC) count, white blood cell(WBC) count, absolute PNL and monocyte (Mo) counts, and platelet count. We also determined total absolute T- and B- cell counts, CD4⁺ and CD8⁺ lymphocyte counts and helper/suppressor (H/S) lymphocyte ratio. Results were obtained before treatment and after a week beginning the day the patient received the first dose of treatment. Results were as follows:

1st group: (7 patients; received 5 μg/kg/d G-CSF for 4 days s.c.): Hb level and RBC, WBC, PNL and total lymphocyte counts increased significantly.

2nd group: (7 patients; received 30 mg/kg/d high-dose methylprednisolone (HDMP) for 4 days p.o. RBC, WBC, PNL, Mo counts, total lymphocyte, T-, B-, CD4⁺ and CD8⁺ lymphocyte counts increased and H/S ratio decreased significantly.

3nd group: (5 patients; received G-CSF+HDMP at same doses for 4 days) Hb level and WBC, PNL and total lymphocyte counts increased significantly.

4nd group: (9 patients; received no treatment) Hb level and RBC, WBC, PNL, Mo total lymphocyte, T-lymphocyte and CD8⁺ lymphocyte counts increased and H/S ratio decreased significantly.

In conclusion, no therapy was superior in the control group to increase Hb, RBC, WBC and PNL in this study. HDMP caused an increase in all lymphocyte subtypes and a decrease in H/S ratio, G-CSF treatment caused no change in lymphocyte subtypes. These results should be taken under serious consideration in patients receiving peripheral blood stem cell transplantation after cytokine-induced mobilization.