[Effect of G-CSF and M-CSF on busulfan-induced marrow failure in a 91-year old patient with essential thrombocythemia].

A 91-year-old patient with essential thrombocythemia presented with marked bone marrow suppression induced by long-term administration of busulfan. Her pancytopenia extended for over two months even after the cessation of busulfan, suggesting that she had developed a severe decrease in hematopoietic reserve. We administered G-CSF and M-CSF to accelerate recovery from marrow failure and to evaluate the recovery of hematopoiesis. The standard doses of G-CSF and M-CSF increased her neutrophil and platelet counts sufficiently but only transiently. Transient eosinophilia was also noted after cessation of M-CSF. The possibility that the expansion of abnormal clone(s) induced the transient increase in platelet and eosinophil counts could not be completely excluded. We suggest that the administration of hematopoietic growth factors should be limited to patients, irrespective of age, who present marked clinical symptoms attributable to marrow failure when the patient has a chronic myeloproliferative disorder.