Is there potential for granulocyte or granulocyte-macrophage colony stimulating factors in radiotherapy?

The purpose of this communication was to explore which situations in radiotherapy might benefit from concomitant administration of haematopoietic growth factors (HGF). Only large-field radiotherapy is likely to induce bone marrow depression, such as irradiation of Hodgkin's disease. Therefore, we studied 122 patients irradiated for Hodgkin's disease, looking at peripheral blood cell count before, during and after the treatment. One hundred and four treatments were preceded by chemotherapy (MOPP and/or ABVD) and the radiation dose was between 36 and 44 Gy in 2 Gy per fraction sessions. Severe leucopenia (grade III WHO) was very uncommon and justified treatment interruption only twice. In both cases, it was paired with thrombocytopenia. No infection developed. It is concluded that when radiotherapy is used alone, prophylactic use of HGFs does not seem justified. This, of course, does not apply to radiochemotherapy combinations, although thorough investigations in this field are still awaited.