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Regulated plasma levels of colony‐stimulating factors, interleukin‐6 and interleukin‐10 in patients with acute leukaemia and non‐Hodgkin's lymphoma undergoing cytoreductive chemotherapy
Author(s) -
Reisbach Gilbert,
Kamp Torsten,
Welzl Gerhard,
Giez Christiane,
Abedinpour Fariborz,
Lodri Antal,
Kaboth Werner,
Dörmer Peter,
Nerl Christoph
Publication year - 1996
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.1996.434972.x
Subject(s) - medicine , chemotherapy , lymphoma , gastroenterology , granulocyte colony stimulating factor , non hodgkin's lymphoma , granulocyte macrophage colony stimulating factor , interleukin 11 , white blood cell , immunology , cytokine , interleukin
Endogenous plasma levels of granulocyte colony stimulating factor (G‐CSF), granulocyte‐macrophage colony‐stimulating factor (GM‐CSF), IL‐6 and IL‐10 were measured in a total of 70 patients undergoing cytoreductive chemotherapy for treatment of acute leukaemia or non‐Hodgkin’s lymphomas. The diagnoses were acute myeloid leukaemia (AML; n = 30), acute lymphoblastic leukaemia (ALL; n = 6), non‐Hodgkin’s lymphomas (NHL; n = 11) and other malignant haematological disorders including myelodysplastic syndromes ( n = 23). After chemotherapy, plasma G‐CSF was elevated (mean 5.6 ng/ml; range 1.2–10 ng/ml), and was inversely correlated with white blood cell counts (WBC) ( r = −0.7, P < 0.001). Occurrence of fever (T>38.0°C) during severe myelosuppression (WBC<1 × 10 9 /l) was associated with an additional increase of G‐CSF levels ( P < 0.001). Plasma IL‐6 correlated significantly with fever (range <1 to 1100 pg/ml, mean 130 pg/ml; r = 0.5, P < 0.001) but revealed only a weak association with WBC or platelet counts. In patients treated with recombinant G‐CSF ( n = 9), an association between IL‐6 and fever was still observed after chemotherapy. During the nonfebrile status (total n = 242; AML n = 124), IL‐6 levels remained <9 pg/ml in 90% of cases, whereas G‐CSF increased with leucopenia ( r = −0.72; P < 0.001). In contrast, endogenous GM‐CSF remained normal and IL‐10 showed only a slight increase (21% of samples; maximum 22 pg/ml) in severe leucopenia. In particular, IL‐10 levels did not correlate with G‐CSF or IL‐6 levels. We conclude that systemic release of G‐CSF and IL‐6 is obviously not abrogated by cytoreductive chemotherapy in acute leukaemia and NHL and may add to the therapeutic efficacy of recombinant cytokines. Also, plasma levels of G‐, GM‐CSF or IL‐6 appear to be regulated by separate mechanisms.