Treatment with very low-dose GM-CSF in myelodysplastic syndromes with neutropenia. A report on 28 cases.
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In pediatric patients with various malignancies, the effect of two different doses of recombinant human granulocyte colony-stimulating factor (rhG-CSF) on chemotherapy-induced neutropenia was examined. Each patient was treated with two courses of the same chemotherapeutic regimen. Following each course, either 100 μg/m2 or 250 μg/m2 of rhG-CSF was infused daily starting 48 hours after the cessation of chemotherapy and continuing for 14 consecutive days. A total of 29 patients (34 cycles of therapy) were eligible for the study. Both the duration of neutropenia (<0.5 × 1099/l) and median days from the nadir of neutrophils to recovery, >0.5 × 109/l, were significantly shorter when 250 μg/m2 was given. Moreover, the nadir counts of neutrophils and the duration of fever with neutropenia were, although not significant, in favor of 250 μg/m2 administration. No differences were observed in the frequency and severity of side effects.
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Objective The clinical usefulness of rhG CSF was evaluated in patients with leukopenia and neutropenia induced by high dose combined chemotherapy for osteosarcoma and rhG CSF′s side effects.Methods A series of 58 osteosarcoma patients were divided into study group and control group (according their economic situation) and were treated with same chemotherapy regimen.rhG CSF at a dose of 150 μg/body daily was given subcutaneously 72 h after the termination of chemotherapy for five to seven days in study group.While normal medicine was given in control group.Results rhG CSF significantly increased the total white cell count (WBC) and absolute neutrophil count (ANC) at nadir,and shortened the duration of leukopenia with WBC4 0×10 9/L and ANC2 5×10 9/L,reduced the number of recovery days to normal and increased the completeness rate of chemotherapy.The side effect of rhG CSF was mild and tolerable.Conclusion rhG CSF is effective against the decrease of WBC and ANC,is able to improve chemotherapy′s success rate;using rhG CSF is an effective remedy for preventing and treating the bone marrow arrest induced by chemotherapy.
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Bone marrow suppression
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Objective To investigate the effect of recombined human granulocyte colony-stimulating factor (rhG-CSF) on leukopenia and neutropenia induced by chemotherapy.Methods rhG-CSF began to be used within 24～48 hours after chemotherapy in treatment group,and in control group,rhG-CSF application was started when the blood granulocyte count being low.Results The absolute neutrophil count dropping time was shorter in the treatment group than that in the control group,and the infection rate decreased significantly in the former group.Conclusion This study showed that early treatment with rhG-CSF can decrease the absolute neutrophil count dropping time and infection rate.
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Absolute neutrophil count
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The clinical usefulness of Recombinant Human Granulocyte Colony Stimulating Factor (rhG-CSF, Filgrastim, GRAN) was evaluated in patients with leukopenia and neutropenia following chemotherapy for non-Hodgkin's lymphoma, lung cancer and breast cancer. During chemotherapy when patients' leukocyte count (WBC) fell below 4.0 x 10(9)/L.rhG-CSF(GRAN) at a dose of 75 micrograms/body.day was given subcutaneously 48 hours after the termination of chemotherapy. The results indicated that rhG-CSF(GRAN) could elevate nadirs of WBC and significantly shortened leukopenic period with WBC below 4.0 x 10(9)/L and expedited the recovery of WBC. rhG-CSF (GRAN)'s side effects were mild.
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AbstractFifty-six children with various malignancies were treated subcutaneously with recombinant human granulocyte colony-stimulating factor (rhG-CSF, KRN 8601) for neutropenia induced by cancer chemotherapy. Patients the first chemotherapy without rhG-CSF (control course). In the second course, rhG-CSF was given once daily, starting 3 days after completion of identical chemotherapy (day 3) and continuing until day 12. At day 12, the white blood counts and neutrophil counts were found to be 6.8 and 30 times higher in the rhG-CSF course than in the control course (P 0001). Nadirs of white blood counts and neutrophils were significantly elevated in the rhG-CSF course (P 003 and. 0001, respectively). rhG-CSF administration shortened the neutropenic period in the majority of patients. Children tolerated the rhG-CSF administration well and we have hereby confirmed that rhG-CSF administration is useful for proceeding with chemotherapy in children with cancer.Key Words: drug-induced neutropeniarhG-CSFsubcutaneous administration
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A clinical trial of recombinant human granulocyte colony-stimulating factor (rG-CSF), produced by Chinese hamster ovary cells, was conducted in 66 patients receiving intensive chemotherapy for non-Hodgkin's lymphoma. Each patient received 2 cycles of CHOP therapy, and one cycle of them was performed with rG-CSF treatment and another one without rG-CSF treatment, in a cross-over fashion. rG-CSF (0.4, 2, 5, 10 micrograms/kg/day) was given intravenously or subcutaneously to each patient for 14 days from 2 days after initiation of the chemotherapy. rG-CSF increased the absolute neutrophil counts (ANC) at nadir, and reduced the period of neutropenia with ANC less than 1,000/mm3 and also the period for restoration to ANC greater than or equal to 2,000/mm3 after initiation of chemotherapy. These effects were remarkable at doses of more than 5 micrograms/kg/day intravenously and 2 micrograms/kg/day subcutaneously. Fourteen infective episodes were observed during the cycles of chemotherapy without rG-CSF treatment, while 7 infective episodes were observed during the cycles with rG-CSF treatment. rG-CSF was well tolerated. These results demonstrated that rG-CSF was effective in neutropenia induced by cancer chemotherapy at a intravenous dose of 5 micrograms/kg/day and a subcutaneous does of 2 micrograms/kg/day.
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Objective To determine the preventive effect of recombinant human granulocyte colony-stimulating factor(rhG-CSF) used for chemotherapy-induced myelosuppression in Chinese tumor patients to guide clinical rational drug use.Methods Tumor patients who appeared grade 3 to 4 myelosuppression after upper-period chemotherapy were chosen in the retrospective study.Group A was preventively treated with rhG-CSF between 24-48 h after the chemotherapy,and group B was treated with rhG-CSF after the myelosuppression.Myelosuppression induced by chemotherapy was compared between the 2 groups.Results A total of 145 tumor patients were enrolled,with 61 patients in group A,and 84 in group B.The rate of leukopenia was 26.23% and 79.76%,and the rate of neutropenia was 19.67% and 78.57% in group A and the group B respectively.There was significant difference between the 2 groups(P0.05).RhG-CSF had no effect on the hemoglobin and platelet.The antibiotics use in group A was lower than that in group B.Conclusion Prophylactic use of rhG-CSF between 24-48 h after the chemotherapy can reduce the myelosuppression and infection in tumor patients with grade 3 to 4 myelosuppression after the upper-period chemotherapy.
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