Experience in treating a gingival carcinoma patient with autoimmune leukopenia by combination therapy with human granulocyte colony stimulating factor.

概要

論文の詳細を見る
Despite advances in cancer therapy, it is very difficult to treat patients with leukopenia because of consequent infection. Recently, recombinant human granulocyte-colony stimulating factor (rhG-CSF) has been developed to enhance neutrophil number and function and thereby improve leukopenia. In this paper, we report our experience in treating a gingival carcinoma patient with autoimmune leukopenia by combination therapy with rhG-CSF. A 53-year-old female patient with leukopenia (WBC 1, 200/mm3) was referred to our clinic and diagnosed as having lower gingival carcinoma (T2NOMO, Stage II). Laboratory data suggested that the leukopenia was due to autoimmunity. Since bone marrow aspiration showed a normal profile and a trial dose of rhG-CSF increased WBC rapidly, we decided to perform tumor excision and postoperative combined chemotherapy with rhG-CSF. Treatment with rhG-CSF in a dose of 2 μg/kg per day subcutaneously was done in three periods. The first period was for 14 days starting from 1 day before operation. After surgery two cycles were given. The first cycle was for 10 days starting on the day after terminating chemotherapy with CDDP and PEP, and the second cycle was for 16 days. WBC was maintanined at 10, 000-20, 000 cells/mm3 during rhG-CSF treatment. Postoperative infection and chemotherapy-related side effects were not noted.