Granulocyte and granulocyte-macrophage colony-stimulating factors for treatment of neutropenia in glycogen storage disease type Ib

J Pediatr. 1991 Nov;119(5):748-54. doi: 10.1016/s0022-3476(05)80290-2.


Two children with glycogen storage disease type Ib associated with numerous recurrent bacterial infections as a result of neutropenia and neutrophil dysfunction were treated with recombinant human granulocyte colony-stimulating factor (G-CSF). One of the two patients was previously treated with recombinant human granulocyte-macrophage colony-stimulating factor (GM-CSF); therapy had to be discontinued because of severe local side effects. Both colony-stimulating factors at dosages of 3 and 8 micrograms/kg/per day, respectively, increased the average neutrophil counts from less than 300 cells/microliters to more than 1200 cells/microliters. Two subpopulations of neutrophils could be identified by their capacity to produce H2O2: one subpopulation generated H2O2 normally and a second was defective in H2O2 production. The doses of G-CSF effectively enhanced and maintained that subpopulation of neutrophils which produced normal amounts of H2O2. Moreover, these colony-stimulating factor-induced neutrophils demonstrated effective phagocytosis of zymosan particles and killing of staphylococci. Chemotaxis was decreased and could not be normalized by treatment with G-CSF. We conclude that maintenance treatment with G-CSF improved the quality of life in both patients: The number and severity of bacterial infections decreased markedly during treatment. Long-term treatment with G-CSF (12 and 10 months, respectively) was well tolerated, and no adverse clinical events were observed.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Bacteriolysis
  • Chemotaxis, Leukocyte / physiology
  • Female
  • Flow Cytometry
  • Glycogen Storage Disease Type I / physiopathology
  • Glycogen Storage Disease Type I / therapy*
  • Granulocyte Colony-Stimulating Factor / administration & dosage
  • Granulocyte Colony-Stimulating Factor / therapeutic use*
  • Granulocyte-Macrophage Colony-Stimulating Factor / administration & dosage
  • Granulocyte-Macrophage Colony-Stimulating Factor / therapeutic use*
  • Humans
  • Hydrogen Peroxide / metabolism
  • Infant
  • Injections, Subcutaneous
  • Leukocyte Count
  • Male
  • Neutropenia / physiopathology
  • Neutropenia / therapy*
  • Neutrophils / metabolism
  • Neutrophils / pathology
  • Neutrophils / physiology
  • Recombinant Proteins
  • Staphylococcus aureus / physiology
  • Superoxides / metabolism


  • Recombinant Proteins
  • Superoxides
  • Granulocyte Colony-Stimulating Factor
  • Granulocyte-Macrophage Colony-Stimulating Factor
  • Hydrogen Peroxide