Red Blood Cells (RBC) and High Fluorescence Reticulocytes (HFR) production increased by induction chemotherapy and GM-CSF plus G-CSF in peripheral blood of breast cancer patients

The preservation of erythrocytes is important during cytostatic chemotherapy. To study the synergistic effect of GM-CSF plus G-CSF on the red blood recovery, we looked at the kinetics of red blood cells, total reticulocytes and High Fluorescence Reticulocytes (HFR) from peripheral blood of 26 breast cancer patients, between 2 cycles of chemotherapy. After four days of TNCF (Thp-doxorubicin, Vinorelbine, Cyclophosphamide, Fluorouracil) treatment, 12 patients received either GM-CSF or G-CSF (D5-D16) and 14 received both of them (GM-CSF, D5-D14 and G-CSF, D10-D14). Our results showed a significantly lesser RBC decrease for patients receiving both CSFs versus only one CSF (p < 0.05). This greater RBC preservation was explained by the increase of HFR and total reticulocytes from D12 to D17 in the peripheral blood of patients receiving the two CSFs, with significantly values greater than that of patients receiving one CSF (p < 0.01) it showed that the synergistic GM-CSFplus G-CSF effect observed previously on PBPC results in a positive effect on erythroid lineage. GM-CSF plus G-CSF association exhibit in vivo multilineage (myeloid and erythroid) activity showing the interest to use different cytokines in combination to obtain a better hematological recovery after induction chemotherapy as well as a better quality of PBPC mobilization for transplantation after high-dose chemotherapy.