Bladder Cancer Producing Granulocyte Colony-Stimulating Factor

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Abstract
We report the production of granulocyte colony-stimulating factor (G-CSF) in a patient with bladder cancer, which was confirmed by immunofluorescence staining of tumor tissue. A 48-year-old man died of bladder cancer (transitional-cell carcinoma, grade 3). An autopsy revealed multiple metastases to the liver, lungs, vertebrae, prostate, and cerebellum. The patient had had marked leukocytosis (maximum, 141.0×109 per liter), first observed three months before his death, but no increase in the number of immature granulocytes or eosinophils. The serum G-CSF level, measured by enzyme immunoassay,1 was 2359 ng per liter (normal, <30) one month before his death. He had received cisplatin-based chemotherapy for nine months and irradiation of the right ilium and acetabulum. He had not received G-CSF at any time. On indirect immunofluorescence testing with a murine monoclonal antibody against human G-CSF, G-CSF was found in most of the cancer cells in the primary tumor and in the lesions that had metastasized to the liver and lungs ( Fig. 1 ).