Variation of serum G-CSF level in APL treated with all-trans retinoic acid

Objective: To detect the level of serum G-CSE frompatients with acute promyelocytic leukemia pre- or posttreatment with ATRA and analyze the relationshipbetween serum G-CSF and hyperleukocytosis.Methods: Enzyme-linked immunosorbent assay (ELISA)method was developed and used in detecting serum GCSF. Linear correlation test and Spearman rank ordercorrelation coefficient were used as the statisticalanalytical method. Results: The levels of serum GCSF increased in 11.4% (4135) of APL patients (equal ofmore than 0.095 nglml). It was also found that serum GCSF level in 25 APL patients started to increase fromthe 6th day to 12th day and then gradually declinedafter treatment with ATRA. Both serum G-CSF andWBC numbers increase in 72% (18125) patients; noobvious variation of WBC and increase of serum G-CSFand augmentation of WBC were seen in 12% (3125) ofthe cases with APL. It was also demonstrated thatserum G-CSF level was statistically related to the WBCnumber (r=0.275, P<0.05), promyelocytes (r=0.2015,P<0.05) or more matured granulocytes (r=0.2055 P<0.05)by Spearman rank correlation analysis. Conclusion:The results of this study strongly indicate that G-CSFvariation in patients with APL after treatment withATRA plays an important role in hyperleukocytosis ofWBC increase.