engleski

The effects of Filgrastim (granulocyte colony stimulating factor, G-CSF) on leukopenia in children with solid tumors

Neutropenia is common in patients given cancer chemotherapy and may be severe, with cell counts below 0.5 x 109/L. Recombinant granulocyte colony stimulating factor (filgrastim ; G-CSF) specifically stimulates the production of neutrophils from the progenitor cells in bone marrow, accelerates the maturation and increases the cell counts in peripheral blood. In this work we present the results of the application of filgrastim (NeupogenR, Amgen-Roche) in 93 children treated with chemotherapy for various types of solid tumors (24 neuroblastomas, 19 Ewing sarcomas, 3 renal sarcomas, 21 osteosarcomas, 11 rhabdomyosarcomas, 4 PNETs, 5 ganglioneuroblastomas and 6 other solid tumors). The age of the patients was 3 to 18 years. Filgrastim was applied subcutaneously or (in combination with other treatment) intravenously. The doses were lower than usually recommended and ranged from 4.2 to 10.0 mg/kg. Side effects have not been observed in any patient. In the majority of the patients a marked increase of the leukocyte and neutrophil counts and a shift to the left occurred after the 1st and the 2nd application of filgrastim. The treatment significantly accelerated the recovery of reticulocytes at p < 0.01 in 58% of the children and caused the appearance of acidophilic erythroblasts in peripheral blood. No effect on the platelet recovery was noted. In conclusion, the children tolerated the application of filgrastim exceedingly well, and almost all responded with increases of the leukocyte, neutrophil and reticulocyte counts. Preventive application of filgrastim is justified in children with solid tumors receiving aggressive antineoplastic therapy and threatened with leukocytopenia. The significant increase of the reticulocyte count suggests an effect of filgrastim on erythropoietic progenitor cells.

chemotherapy; neutropenia; filgrastim (G-CSF)

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