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Endogenous haemopoietic growth factors in neutropenia and infection
Author(s) -
Cebon Jonathan,
Layton Judith E.,
Maher Darryl,
Morstyn George
Publication year - 1994
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 - 10.1111/j.1365-2141.1994.tb04725.x
Subject(s) - neutropenia , medicine , bilirubin , creatinine , absolute neutrophil count , gastroenterology , leukopenia , granulocyte colony stimulating factor , granulocyte , immunology , chemotherapy
Summary Haemopoietic growth factors (HGFs) are being administered to patients with neutropenic fever; however, little is known about the endogenous HGF response in these patients. Specific assays were used to study four HGFs, granulocyte (G‐) CSF, granulocyte‐macrophage (GM‐) CSF, macrophage (M‐) CSF and interleukin (IL‐) 6 levels in the blood of patients with neutropenic fever (46 episodes). For comparison, levels were also measured in three control populations: normals (20), afebrile neutropenic (14), and bacteraemic but not neutropenic patients (20). In febrile patients, levels of G‐CSF (median, range) (0·46, <0·10–142 ng/ml), IL‐6 (0·054, 0·05·24–3 ng/ml), and M‐CSF (18·5, 9·9–79·1 ng/ml) were elevated compared with afebrile subjects (<0·10, <0·0–1–6·2 ng/ml), (0·008, 0·002–0·024 ng/ml) and (6·45, < 5·0–31·3 ng/ml) respectively. GM‐CSF was not elevated (<0·02, <0·02–8·0 ng/ml) compared with afebrile subjects (0·021, < 0·02–0·20 ng/ ml). Variables significantly associated ( P < 0·05) with elevated cytokine levels were determined by multiple regression analyses. Factors associated with G‐CSF elevation were fever, neutropenia, pathogen type and raised bilirubin and creatinine. In contrast, neutropenia was not associated with IL‐6 elevation although there was an association between IL‐6 elevation and fever, Gram‐negative and fungal infections and raised creatinine and bilirubin. M‐CSF elevation was associated with fever, renal impairment and known pathogen. Elevated G‐CSF and IL‐6 levels normalized rapidly (hoursdays) with the resolution of infection, whereas M‐CSF concentrations remained elevated for up to 10 d. Cytokine levels remained elevated in septic neutropenic patients who did not recover. In summary, G‐CSF, IL‐6 and M‐CSF levels were significantly elevated in sepsis. In contrast, GM‐CSF levels were not elevated. These studies should assist the development of therapeutic strategies using HGFs in the treatment of sepsis.