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KMID : 0391319930030010067
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Korean Journal of Biological Response Modifiers
1993 Volume.3 No. 1 p.67 ~ p.78
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Clinical Effects of Neutrogin (Recombinant Human Granulocyte-Colony Stimulating Factor) on Neutropenia Induced by Chemotherapy for Lung Cancer
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홍원선외33인:
저자없음:No authors listed
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Abstract
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This study was undertaken to investigate the clinical effects of Neutrogin (recombinant human granulocyte colony0stimulating factor) in 22 patients with lung cancer (12 small cell lung cancer and 10 non-small cell lung cancer) who received two courses of VAP chemotherapy. VAP chemotherapy was given on days of an every 28 day course; 100mg/㎡ of VP-16 on day 1-3, 40mg/㎡ of adriamycin on day 1, and 25mg/㎡ of cisplatin on day 1-3. All patients were treated with VAP chemotherapy alone in the first course of chemotherapy which was used as a control course. During the second course. Neutrogin was given at a dose 2㎍/kg/day subcutaneously for 14 days from day 6. In the first course, leukocyte and neutrophil counts in the peripheral blood decreased gradually and subsequently increased after the nadir to the inital levels. In the second course, leukocyte and neutrophil counts were significantly elevated with a biphasic shape after the sixth day of the second course. The first peak was observed on day 8 after the initiation of chemotherapy and a second peak was observed on day 18. Platelet counts also decreased after chemotherapy, however there was no significant difference in platelet counts between the two courses. Neutrogin significantly increased in the nadir count of leukocyte and neutrophil, however, the nadir of platelet count in the second course was not different from that in the first course. The decrease in the number of days to reach the nadirs of leukocytes and nuetrophils was observed in the second course. The mean duration of leukopenia and neutropenia as well las the mean recovery time required for leukocytes greater than 4,000/㎣ and 2,000/㎣ and for neutrophils to greater than 2,000/㎣ and 1,000/㎣ after the nadir were significantly decreased in the second course compare with those observed in the first course. The recovery time from day 1 of each chemotherapy to a leukocyte count of more than 4,000/㎣ and to a neutrophil count of more than 2,000/㎣ was also significantly reduced in the second course as compared with the first course. In 16 patients (72.7%). Neutrogin was temporarily stopped with the duration of discontinuation being 3.7±1.6 days, because of the elevation of leukocyte and neutrophil counts above 100,000/㎣ AND 5,000/㎣, RESPECTIVLEY. In the first course, five patients (22.7%) developed febrile and infectious episodes, all of which recovered after antibiotic therapy, while neiter febrile not infections episode was observed was observed in the second course. Four patients (18.2%) ecperienced mild side effects of Neutrogin, such as low-grade fever, lumbago and elevation of serum lactic dehydrogenase. All of them were well tolerated and recovered without specific treatment. The overall evaluation for the effectiveness and usefulness of Neutrogin was performed according to the strict evaluation criteria, the effectiveness and usefulness were 81.8% and 72.7%, respectively. The results of the present study demonstrating that Neutrogin significantly elevated the nadirs of leukocytes and neutrophils reduced the duration of neutropenia be extremely effective and useful to prevent chemotherapy-induced leukopenia and neutropenia and to accelerate the recovery from these complications.
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KEYWORD
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