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KMID : 0869620000170040501
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Journal of Korean Society of Hospital Pharmacists
2000 Volume.17 No. 4 p.501 ~ p.511
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The Comparison of Lenograstim and Filgrastim on Hematologic Recovery after Autologous Peripheral Blood Stem Cell Transplantation
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김인향/Kim, In Hyang
오정미/박성규/김정태/Oh, Jung Mi/Park, Sung Kyu/Kim, Jung Tae
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Abstract
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High-dose chemotherapy (HDCT) with autogolous peripheral blood stem cell transplantation (PBSCT) is a therapeutic option for patients with chemotherapy-sensitive malignancies who have relapses. However, following treatment with high-dose chemotherapy and PBSCT, patients develop severe myelosuppression including neutropenia, thrombocytopenia and anemia. The consequence of neutropenia is the susceptibility of patients to fever and infection, which require diagnostic procedures and the use of antibiotics, antifungal, and antiviral agents. The incidence of infections in known to increase with the duration and severity of neutropenia. Hematopoietic growth factors such as recombinant granulocyte colony-stimulating factors have shown to accelerate the hematopoietic recovery after bone marrow grafting. A retrospective case-controlled study was performed to compare the efficacy and side effects of two different forms of recombinant granuylocyte colony-stimulating factors (G-CSF), lenograstim (glycosylated) and filgrastim (nonglycosylated) in 85 patients after high-dose chemotherapy and peripheral blood stem cell transplantation. 49 patients who received lenograstim 250㎍/day, and 36 patients who received filgrastim 300㎍/day one day post stem cell infusion were evaluated. Absolute neutrophil count (ANC) recovery to above 500㎣ for 3 consecutive days was achieved earlier in filgrastim-treated group than lenograstim-treated group (13.2±8.0 days vs 19.0±10.0 days, p=0.0004). Time to WBC recovery above 4,000/㎣ was achieved earlier in filgrastim-treated group than lenograstim-treated group (16.9±9.7 days vs 29.9±16.6 days, p=0.001). The platelet recovery was also achieved earlier in filgrastim-treated group than lenograstim-treated group (19.5±11.6 days vs 27.2±13.8 days, p=0.0006). Furthermore, filgrastim-treated patients received fewer days of antibiotic administration and spent less time in hospital. However, days of neutropenic fever, types of antibiotics administered and transfusion times were similar between the groups. There was no significant differences in drug-related toxicity between the groups. In patients undergoing autologous PBSCT following HDCT for neoplastic disease, filgrastim significantly reduced the duration of neutropenia and led to earlier hospital discharge than lenograstim in this study.
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