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Biological and Clinical Correlates after Chemotherapy and Granulocyte Colony‐Stimulating Factor Administration
Author(s) -
Higa Gerald M.,
DeVore Russell F.,
Auber Miklos L.,
Lynch Joseph P.,
Landreth Kenneth S.
Publication year - 1998
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1002/j.1875-9114.1998.tb03819.x
Subject(s) - granulocyte colony stimulating factor , medicine , granulopoiesis , chemotherapy , absolute neutrophil count , filgrastim , granulocyte , neutropenia , oncology , immunology , haematopoiesis , chemotherapy regimen , regimen , gastroenterology , stem cell , biology , genetics
Study Objective . To evaluate specific biological markers to improve understanding and use of granulocyte colony‐stimulating factor (G‐CSF) in patients receiving chemotherapy. Design . Prospective, randomized study. Setting . University‐affiliated hospital and cancer center. Patients . Twenty‐five patients randomized to begin G‐CSF either 24 hours after chemotherapy (standard arm), or on the day the absolute neutrophil count (ANC) was below 1000/mm 3 after chemotherapy (delayed arm). Interventions . To determine the effect of G‐CSF on granulopoiesis, peripheral blood mononuclear cells were assayed by semisolid culture medium and flow cytometry for granulocyte progenitors and clonogenic CD34 antigen‐positive cells. These biological markers were correlated with G‐CSF administration schedules and the ANC. Measurements and Main Results . The effect of timing of G‐CSF administration on rate of neutrophil recovery, duration of neutropenia, length of G‐CSF therapy, delays of chemotherapy cycles, and neutropenic fever events was evaluated. Regardless of G‐CSF schedule or chemotherapy regimen, the appearance of mobilized hematopoietic progenitors begins at the neutrophil nadir and parallels granulocyte recovery. Our data also demonstrate that proper timing of G‐CSF administration produces similar rates of neutrophil recovery and comparable clinical outcomes. Conclusion . Based on the correlation between biological markers and ANC, we propose that the postchemotherapy ANC is a surrogate marker of renewed granulopoietic activity. The relevance of this finding in relationship to the clinical application of G‐CSF remains to be further defined.