The safety and clinical efficacy of recombinant human granulocyte colony stimulating factor injection for colon cancer patients undergoing chemotherapy

Summary Objective: The present study was designed to evaluate safety and efficacy of recombinant human granulocyte colony stimulating factor (G-CSF) injection and whether this regimen could reduce the incidence of adverse events caused by chemotherapy. Method: A total of 100 patients with colon cancer who were treated with chemotherapy in our hospital from January 2011 to December 2014 were randomly divided into two groups, with 50 patients in each group. The patients in the treatment group received G-CSF 24 hours after chemotherapy for consecutive three days; the patients in the control group received the same dose of normal saline. Routine blood tests were performed 7 days and 14 days after chemotherapy. Results: Compared with the control group, the incidences of febrile neutropenia and leukocytopenia in the treatment group were significantly lower (p<0.05). In addition, the incidence of liver dysfunction in the treatment group was lower than that of the control group, without statistical significance. The incidence of myalgia in the treatment was higher than that of the control group without statistical significance. Conclusion: The present study indicated that G-CSF injection after chemotherapy is safe and effective for preventing adverse events in colon cancer patients with chemotherapy.

Sangramiento digestivo asociado al tratamiento con filgrastim: efecto secundario infrecuente / Digestive bleeding associated to treatment with filgrastin: infrequent adverse side effect

El factor estimulante de colonias granulocíticas (FEC-G), Filgrastim, es utilizado cada día con mayor frecuencia como agente movilizador para la obtención de concentrado de células progenitoras de sangre periférica. Generalmente, la movilización con FEC-G es bien tolerada aunque se ha reportado un amplio espectro de reacciones adversas asociadas a su uso, que incluyen: cefalea, poliartralgia y mialgia entre las más comunes. Ocasionalmente se han comunicado epistaxis y hemorragia retiniana. Los fenómenos tromboembólicos, el distrés respiratorio, la ruptura esplénica, la hemorragia intracraneal son algunos de los efectos secundarios rara vez comunicados. Las manifestaciones digestivas como náuseas y vómitos son frecuentes, no así los sangramientos del tracto digestivo...

Síndrome de Sweet asociado a leucemia mieloide aguda y factor estimulante de colonias de granulocitos: Caso clínico / Sweet's syndrome associated with acute myeloid leukemia: Report of one case

Sweet's syndrome, also known as acute febrile neutrophilic dermatosis, is characterized by fever, neutrophilia, erythematous and tender skin lesions that typically show a diffuse infiltrate of neutrophils in the upper dermis. This disorder has been associated with myeloproliferative syndromes. We report the case of a 53-year-old woman with an acute myeloid leukemia, presenting a Sweet's syndrome. A worsening of cutaneous lesions injuries was observed when granulocyte colony stimulating factor was added to treatment.

Polyserositis [concato's disease] due to granulocyte colony stimulating factor therapy for lymphoma

Polyserositis is defined as general inflammation of serous membranes associated with serous effusion due to many causes. In this study, we evaluated polyserositis as a rare complication of GCSF therapy. A 26-year-old man with a history of lymphoma was referred to our hospital complaining of dyspnea, tachycardia, tachypnea, chest pain, bilateral pleural effusion, ascites and massive pericardial effusion after 5 days of treatment with GCSF. After 7 days of treatment with indomethacin, dexamethasone and discontinuation of GCSF, the patient improved and was referred to an oncologist for chemotherapy of lymphoma. Based on this case report, we should consider various causes of pleural effusion in a patient with lymphoma, and use drugs with caution in such patients as they may be predisposed to dyspnea and fluid retention

Comparing efficacy and side effects of Pd grastim and neupogen for prevention of neutropenia after chemotherapy in children

G-CSF is one of the new medications that may reduce duration and severity of neutropenia after chemotherapy. Two forms of G-CSF are now available in Iran: Neupogen [original form], and new production of Iran named Pd-Grastin. We decided to compare the efficacy and side effects of these two forms of the drug. Absolute Neutrophil count [ANC], total WBC, platelet count [on the 15th day of chemotherapy], and event of fever and neutropenia in this period, were measured after 60 courses of chemotherapy and 4 days of G-CSF, in two separate but the same patients groups, Pd-Grastim [group 1] and Neupogen [group 2]. Mean values of WBC count, ANC, and platelet count were similar [P.V.>0.05]. No significant difference was observed for episodes of neutropenia [ANC <500], event of fever and neutropenia, and days of hospitalization between these groups. Effectiveness and also side effects of Pd-Grastin and Neupogen were similar. Lower cost of Pd-Grastim was the only significant difference between these two forms of G-CSF. Pd-Grastim may be preferred to Neupogen in Iran, because of the same effectiveness but lower cost

Increased levels of multiple forms of dihydrofolate reductase in peripheral blood leucocytes of cancer patients receiving haematopoietic colony-stimulating factors: interim analysis

The precise mechanism whereby granulocytes proliferate when haematopoietic colony stimulating factors (CSFs) are used in neutropenic cancer patients is poorly understood. The purpose of this study was to investigate whether these cytokines bring about leucocyte proliferation by increasing the levels of multiple forms of dihydrofolate reductase (DHFR). Blood samples were collected from 36 cancer patients (25 males and 11 females) with chemotherapy-induced neutropenia. One sample of blood from each patient was obtained before therapy either with CSF, such as granulocyte colony stimulating factor (G-CSF) and granulocyte-macrophage colony stimulating factor (GM-CSF) or with placebo, and another one at the time of resolution of neutropenia. Peripheral blood leucocytes in these blood samples were counted, separated and lysed. From lysates, cytoplasmic samples were prepared and analyzed for active DHFR by a methotrexate-binding assay and for total immunoreactive DHFR by an enzyme linked immunosorbent assay. The increase in total leucocyte count (TLC) was most prominent (P < 0.005) in the CSF group and less so (P < 0.05) in the placebo group. The mean +/- SD concentration values of active DHFR before and after stimulation with GM-CSF found were to be 0.34 +/- 0.4 ng/mg protein and 0.99 +/- 0.82 ng/mg protein, respectively, and in the group treated with G-CSF, 0.24 +/- 0.32 ng/mg protein and 1.18 +/- 2.4 ng/mg protein, respectively. This increase in active DHFR after stimulation with CSF was statistically significant (P <0.05). Similarly, concentration values of immunoreactive but nonfunctional form of DHFR (IRE) were 110 +/- 97 ng/mg protein and 605 +/- 475 ng/mg protein before and after stimulation with GM-CSF, and 115 +/- 165 ng/mg protein and 1,054 +/- 1,095 ng/ mg protein before and after stimulation with G-CSF. This increase in concentration of IRE after stimulation with GM-CSF or G-CSF was statistically significant (P < 0.005). In the control group, there was an increase in the concentration of both active DHFR and IRE after treatment with placebo. However, this was not statistically significant. Resolution of neutropenia was quicker in the groups treated with CSF compared to the control group. Results of this study indicate that colony stimulating factors (G-CSF and GM-CSF) induce white cell proliferation by increasing the levels of multiple forms of DHFR.

The possible cost effectiveness of peripheral blood stem cell mobilization with clophosphamide and the late addition of G-CSF

The purpose of this study was to develop a cost-effective protocol for the mobilization of peripheral blood stem cells (PBSC) in patients with malignancy. Thirty consecutive patients were randomized to mobilize PBSC with the late addition of a standard 250 microg dose of G-CSF (Neutrogen) from day 8 or early addition of the same dose of G-CSF from day 2, following cyclophosphamide (CY) 4 g/m2. The median yield of CD34+ cells from evaluated patients was 7.87 x 10(6)/kg (range, 2.06-27.25), collected in a median of four apheresis (range, 2-9). Target CD34 + cell doses > or = 2.0 x 10(6)/kg were achieved in all patients able to be evaluated. There were no statistically significant differences in CD34+ cell yields or toxicities. Overall engraftment occurred with median days to neutrophils > or = 0.5 x 10(9)/L or platelets > 20 x 10(9)/L of 11 and 17 days, respectively. However, the duration of G-CSF administration was markedly shorter in the late use of G-CSF group than in the early use of G-CSF group, with a median of 9 days compared with 15 days (p>0.001). PBSC harvesting after priming with CY plus delayed use of G-CSF made it a safe and cost-effective procedure.