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KMID : 0391319930030010055
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Korean Journal of Biological Response Modifiers
1993 Volume.3 No. 1 p.55 ~ p.66
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Clinical Effects of Grasin (Recombinant Human Granulocyte-Colony Stimulating Factor) on Leukopenia Induced by VAP Chemotherapy in Patients with Lung Cancer
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홍원선외33인:
저자없음:No authors listed
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Abstract
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Clinical effects of Grasin (recombinant human granulocyte colony-stimulating factor, rhG-CSF) were investigated in 30 patients receiving chemotherapy for lung cancer (14 small cell lung cancer and 16 non-small lung cancer0. Each patient was treated with two cycles of VAP chemotherapy (VP-16; 100mg/㎡ day 1-3, adriamycin; 40mg/㎡ day 1, and cisplatin; 25mg/㎡ day 1-3) In the first cycle of chemotherapy, patients received chemotherapy alone, while in the second cycle Grasi was given at a dose of 75㎍/body/day subcutaneously for 14 days from day 6to day 19. In the first cycle leukocyte and neutrophil counts decreased gradually and subsequently increased after the nadir to the inital levels. In the second cycle, Grasin significantly elevated leukocyte and neutrophil counts in the peripheral blood after day 6 of the second cycle. The leukocyte and neutrophil counts were demonstrated to be a biphasic response consisting of a first peak observed on day 8 and a second peak obseved cycle compared with the first cycle, however, that of platelet in second cycle was similar to second cycle compared with the first cycle, however, that of platelet in the second cycle was similar to the first cycle, although platelet count also decreased considerably after the chemotherapy. No significant differences in days to reach the nadirs of leukocytes and neutrophils were observed between the first an the second cycle. Grasin significantly shortened the period of leukopenia and neutropenia. The recovery time required for leukocytes to reach more than 4,000/㎣ and 2,000/㎣ and for neutrophils to reach more than 2,000㎣ and 1,000/㎣ after the nadir was significantly reduced in the second cycle compared with the first cycle. The time neede for recovery of the leukocyte count to reach 4,000/㎣ or more and of the neutrophil count to reach 2,000/㎣ or more after the start of each chemotherapy was also significantly shorter in the second cycle than the first cycle. In 19 patients (63.3%), the administration of Grasin was temporarily discontinued because of the elevation of leukocyte and neutrophil counts above 100,000㎣, respectively, with the duration of discontinuation of Grasin being 3.9±2.6 days. Febrile and infections episodes were experienced in eight patients (26.7%) in the first cycle, while neither febrile not infectious episode was observed in the second cycle. The side effects of Grasin including abnormal laboratory values, such as headache, myalgia, low-grade fever, skin pruritus, and elevation of LDH and alkaline phosphatase, were observed in four patients (13.3%), although all these untoward reactions were transient and well tolerated. In the overall evaluation, the effectiveness and usefulness of Grasin was 73.3% and 70.0%, respectively. These results demonstrating that Grasin significantly elevated the nadirs of leukocytes and neutrophils, shortened the duration of neutropenia and the recovery time from neutropenia, and observed no significant adverse effects suggest that Grasin is extremely effective and useful for the treatment of neutropenia induced by anticancer chemotherapy.
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