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Blood, 1 October 2004, Vol. 104, No. 7, pp. 1989-1994. Prepublished online as a Blood First Edition Paper on June 17, 2004; DOI 10.1182/blood-2004-02-0628. This Article Full Text (PDF) All Versions of this Article: 2004-02-0628v1 104/7/1989    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Straka, C. Articles by Emmerich, B. Search for Related Content PubMed PubMed Citation Articles by Straka, C. Articles by Emmerich, B. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted February 19, 2004 Accepted May 28, 2004 Responsiveness to G-CSF before leukopenia predicts defense to infection in high-dose chemotherapy recipients Christian Straka*, Fuat Oduncu, Axel Hinke, Hermann Einsele, Evi Drexler, Brigitte Schnabel, Lubomir Arseniev, Jochem Walther, August Koenig, and Bertold Emmerich Medizinische Klinik-Innenstadt, Munich, Germany WISP Research Institute, Langenfeld, Germany Medizinische Klinik Tuebingen, Tuebingen, Germany Medizinische Hochschule Hannover, Hannover, Germany * Corresponding author; email: christian.straka{at}med.uni-muenchen.de. An active assessment of the host capacity to prevent infection during myelosuppression should be beneficial in patients receiving high-dose chemotherapy. A single dose of G-CSF (5 µg/kg) was given to 57 patients with multiple myeloma early after the completion of 85 high-dose chemotherapy (melphalan 200 mg/m2) courses. This provoked a highly variable white blood cell (WBC) peak after 12-14 hours. The median WBC count was 21000/µL (range 6400-60600/µL) after a first high-dose therapy (n=50) and 13500/µL (range 4700-24800/µL) after a second high-dose therapy (n=35). The responsiveness to single G-CSF was associated with the risk of infection during subsequent cytopenia (p=0.003). This association was significant after adjustment for neutropenia duration. Notably, the result of testing G-CSF responsiveness is timely available before the onset of leukopenia and G-CSF responsiveness was more informative than neutropenia duration regarding the risk of infection. Furthermore, there was an association between the responsiveness to G-CSF and stem cell engraftment (p <0.005), which remained significant after adjustment for the number of transplanted CD34+ cells. Our results show for the first time that G-CSF potentially could be used for an early in vivo assessment of defense to infection in recipients of high-dose chemotherapy. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

	Copyright © 2004 by American Society of Hematology         Online ISSN: 1528-0020