Effect of High-Dose Methylprednisolone and G-CSF Treatments on Lymphocyte Subtypes in Neutropenic Children with Acute Lymphoblastic Leukemia: A Pilot Study

Abstract

Treatment of neutropenia with corticosteroids and hemopoietic growth factors may cause alterations in the immune system. This study investigated and compared the effects of various regimens (HDMP, G-CSF, and G-CSF + HDMP) on total lymphocyte counts and subtypes in neutropenic patients with acute lymphoblastic leukemia. Lymphocyte subtypes were studied just prior to treatment and 1 week later. In the HDMP group, total lymphocyte counts and the numbers ofCD3⁺, CD4⁺, CD8⁺, and CD 19⁺ lymphocytes and monocytes increased, while the helper/supressor lymphocyte ratio decreased. No significant changes were seen in lymphocyte subtypes in the G-CSF and G-CSF+ HDMP groups, apart from an increase in total lymphocyte numbers. In the control group there was an increase in the number of CD3⁺ and CD8⁺ lymphocytes and a decrease in the helper/supressor lymphocyte ratio. These results suggest that HDMP has an inducing, rather than a suppressive effect on all lymphocyte subtypes studied.

Key Words:

• G-CSF
• high-dose methylprednisolone
• leukemia
• lymphocyte subtypes
• neutropenia