GCSF usually effectively increases neutrophil count when neutropenia is due to drug, infections (Bacteria,virus fungus) or idiopathic causes. Is there any role of GCSF in severe aplastic anemia?
Bone marrow stromal cells are known to produce G-CSF. A study showed that the ability of stromal cells to release G-CSF is either normal or elevated in patients with AN5).Thus,the rationale for treating the cytopenia of AA patients with G-CSF is not based on findings of G-CSF deficiency but on the expectation that impaired proliferation and differentiation of hematopoietic stem cells may be overcome by pharmacological doses of G-CSF. [1]
rhG-CSF facilitates the recovery of neutrophils and is useful to treat bacterial or fungal infections in AA patients.When the infections subside,rhG-CSFshould be discontinued.Forprophylaxis of severe infections, its use should be restricted to patients with neutrophil counts less than 0.2xlO9/L.
Treatment of the anemia of aplastic anemia patients with recombinant human erythropoietin in combination with granulocyte colony ‐ stimulating factor: a multicenter randomized controlled study,