OBJECTIVE: This study was designed to compare pegfilgrastim and filgrastim in diffuse large B-cell lymphoma (DLBCL) patients treated with a rituximab with cyclophosphamide, hydroxydaunorubicin, oncovin, and prednisone (R-CHOP) regimen in terms of clinical efficacy and cost-effectiveness. METHOD: Clinical efficacy was measured by trough level of absolute neutrophil count (ANC), days of ANC under 50% of baseline value, days of ANC under 90% of baseline value, duration of ANC recovery to baseline value, days of ANC less than 0.5 x 109 cells/L, and difference of peak and trough level of ANC during 1 cycle of R-CHOP regimen. To evaluate cost-effectiveness, total prices of used filgrastim and pegfilgrastim within 1 cycle of R-CHOP were analyzed. RESULTS: In terms of clinical efficacy, trough level of ANC and days to ANC recovery showed statistical significance. The median trough levels of ANC with administration of filgrastim and pegfilgrastim were 0.18 and 1.94 (p = 0.021), respectively, and the median durations of ANC recovery to baseline value were 5.5 days and 2 days (p = 0.023), respectively. For the median days of ANC under 50% of baseline value, days of ANC under 90% of baseline value, days of ANC less than 0.5 x 109 cells/L, and difference of peak and trough level of ANC during 1 cycle of R-CHOP, the pegfilgrastim group performed better than the filgrastim group. However the difference was not statistically significant. In terms of overall expense during 1 cycle of R-CHOP, pegfilgrastim is about 3.43 times more expensive than filgrastim. CONCLUSION: Pegfilgrastim is more efficient than filgrastim in terms of clinical efficacy. In terms of prices, pegfilgrastim is more expensive than filgrastim for patients, but it is more convenient in clinical use. Therefore, pegfilgrastim should be the preferred choice of G-CSF for neutropenic patients. Further comparative study of pegfilgrastim and filgrastim is needed.
Cyclophosphamide ; Granulocyte Colony-Stimulating Factor ; Humans ; Lymphoma, B-Cell ; Neutropenia ; Neutrophils ; Prednisone ; Vincristine ; Filgrastim ; Rituximab

Neutropenia is defined as an absolute neutrophil count (ANC) of <1,500/microliter, and the severity of neutropenia generally can be graded as mild (1,000-1,500/microliter), moderate (500-1,000/microliter), or severe (<500/microliter). This stratification aids in predicting the risk of pyogenic infection because the susceptibility to life-threatening infections is significantly increased in patients with prolonged episodes of severe neutropenia. Especially cancer-related neutropenia carry significant mortality. Neutropenia can develop under various conditions such as decreased bone marrow production, the sequestering of neutrophils, and increased destruction of neutrophils in the peripheral blood. Neutropenia is classified according to the etiology as congenital or acquired, with the latter further defined according to the etiology or pathology. The clinical result is increased risk for infection, which is directly proportional to the severity and duration of the neutropenia. The typical workup of neutropenia starts with a 6-week period in which complete blood counts are measured twice weekly to document the persistence of the neutropenia and whether a cyclic pattern is present. When persistent neutropenia is diagnosed and no spontaneous recovery occurs within 3 months, a more extensive evaluation is advised. Treatment is usually unnecessary for most patients with severe neutropenia, as the majority of patients have a good prognosis. However, for patients who have severe and frequent infections, treatment with filgrastim may prevent infectious complications and improve quality of life.
Blood Cell Count ; Bone Marrow ; Child ; Granulocyte Colony-Stimulating Factor ; Humans ; Neutropenia ; Neutrophils ; Prognosis ; Quality of Life ; Recombinant Proteins ; Filgrastim

PURPOSE: Peripheral blood stem cell transplantation (PBSCT) has been widely used. The optimal time for collection is a critical factor to obtain proper counts of CD34 cell by peripheral blood stem cell collection (PBSC). The purpose of this study was to identify the factors influencing peripheral blood stem cell collection in order to figure out the more effective timing for PBSC. METHOD: The subjects of this study were 189 patients undergoing 3 leukapheresis from January 28, 2005 to December 31, 2006. Group's characteristics, checkup opinion of pre-peripheral blood on the day of harvest & outcome of PBSC were analyzed and evaluated using SAS statistics program after grouping patients as below; group 1-CD34 cell counts <2 x10(6)/kg (n=97); group 2-2x10(6)/kg < or =CD34 cell counts <4x10(6)/kg (n=26); group 3-CD34 cell counts > or =4x10(6)/kg (n=63). RESULTS: Based on outcome of peripheral blood stem cell according to diagnosis, acute myelocytic leukemia (AML) was 65.5% at Group 1, Lymphoma was 21.7% at Group 2 and multiple myeloma (MM) was 70.8% at Group 3. There were significant differences in CD34 cell counts according to diagnosis (p=0.00004). Type of cytokine mobilization according to diagnosis, Lenograsim was using 62.5% of MM & 38.2% of AML and filgrastim is using 22.0% of AML only. Circular peripheral blood CD34 cell counts prior to harvest was 258.1/microliter at Group 3 which was much higher comparing to Group 1 (10.5/microliter) and Group 2 (39.9/microliter) (p<0.001). TNC counts of collected peripheral blood stem cell was 15.36x10(6)/kg at Group 3 microliter and it's much higher than Group 2 (13.16x10(6)/kg) and Group 1 (12.36x10(6)/kg) (p=0.083). There was no significant difference in MNC counts inbetween 3 groups. CONCLUSIONS: Circular peripheral blood CD34+ cell counts prior to harvest was much higher at Group 3 than Group 1 and Group 2. Therefore, the number of CD34+ cells on the day of harvest can be used as an accurate predictor for peripheral blood stem cell.
Cell Count ; Granulocyte Colony-Stimulating Factor ; Humans ; Leukapheresis ; Leukemia, Myeloid, Acute ; Lymphoma ; Multiple Myeloma ; Peripheral Blood Stem Cell Transplantation ; Phenothiazines ; Recombinant Proteins ; Stem Cells ; Filgrastim

OBJECTIVETo analyze the results and influential factors of mobilization and harvesting of autologous peripheral blood stem cell in patients with multiple myeloma (MM).

METHODSRetrospective analysis of peripheral blood stem cell collection data [CD34⁺ cells collected, successful mobilization rate (CD34⁺ cells≥2×10⁶/kg body weight), good mobilization rate (CD34⁺ cells≥5×10⁶/kg body weight)] of 149 multiple myeloma patients who were treated with cyclophosphamide (CTX) or E-CHOP (etoposide+ CTX+epirubicin+vindesine+prednisone) chemotherapy combined with G-CSF mobilization from January 1998 to March 2014. The relevance between gender, age, subtype, DS staging, ISS staging, treatment before mobilization, disease status at mobilization, regiment of mobilizationand the collection results was analyzed.

RESULTSA total of 177 stem cell mobilizations were performed in 149 MM patients, the median CD34⁺ cells harvested were 3.20 (0.13-22.34)×10⁶/kg body weight (BW), successful mobilization rate and good mobilization rate were 74.5% and 27.5%, respectively. The single logistic regression analysis showed that gender, age （>60 ys vs ≤60 ys）, subtype, DS staging (III vs II+I), ISS staging (III vs II+I) and regiment of mobilization (E-CHOP+G-CSF vs ID-CTX+G-CSF) were not correlated with the cell collection or successful mobilization rate (P>0.05). However, successful collection rate of single harvest in old patients (age>60 ys) was lower (P<0.05), andthe good mobilization rate in patients at ISS stage III was lower (P<0.05). The collection results of patients with fewer cycles of treatment (treatment before mobilization ≤6 cycles) and optimal disease status (disease status at mobilization ≥partial remission) were much better. Analysis of logistic factors revealed that treatment efficacy before mobilization affected success rate of collection (P=0.006). Risk of collection failure in patients who received more than 6 cycles of treatment before mobilization was high (OR 3.57, 95% CI 1.45-8.78).

CONCLUSIONGender, age, subtype, DS staging, ISS staging and mobilization regimen did not influence MM patients peripheral blood stem cell collection; but old patients may need twice mobilizations to collect sufficiently. Few cycles of treatment and stable disease status before mobilization is favorable to the mobilization and collection of peripheral blood stem cells.

Antigens, CD34 ; Cyclophosphamide ; Filgrastim ; Granulocyte Colony-Stimulating Factor ; Hematopoietic Stem Cell Mobilization ; Hematopoietic Stem Cells ; Humans ; Multiple Myeloma ; Retrospective Studies ; Treatment Outcome

No abstract available.
Granulocyte Colony-Stimulating Factor* ; Humans ; Recurrence*

Background: Peripheral blood stem cells are today the mains source of cells for transplantation. The number of CD34 in peripheral blood of adult healthy volunteers is very low, so we have to mobilize. Objectives: To apply a protocol to collect CD4 cells in peripheral blood of normal donors mobilized by using G-CSF. Subjects and method: G-CSF (Leukokin) at a dose 10 mcg/kg/day was injected subcutaneously in 5 consecutive days for mobilization CD34 from 5 healthy donors. Count the number of CD34 everyday and collect CD34 cells in 5th \ufffd?6th day by automated blood cell separator (COBE-Spectra), observed clinical and hematilogy, biochemistry symtoms spontaneously. Results: The number of CD34 harvested is 215,5 \ufffd?570,2 x 106 CD34/donor. Almost other of parameters of hematology and biochemistry of donors were normal after one week from the last separation. Conclusion: Mobilization with G-CSF and aphaeresis of periphral blood stem cell from normal donors is feasibility and safety. The number of CD34 can be to allograft for an adult patient.
Hematopoietic Stem Cells ; Granulocyte Colony-Stimulating Factor ;

No abstract available.
Agranulocytosis* ; Granulocyte Colony-Stimulating Factor* ; Granulocytes* ; Humans*

PURPOSE: This study aimed to demonstrate the possible pathogenesis of granulopoiesis in patients of Kawasaki disease(KD) using quantitative analysis of G-CSF, GM-CSF and their CSFr. METHODS: The plasma levels of G-CSF, GM-CSF, G-CSFr and GM-CSFr were studied in 14 patients in the acute phase of KD; 13 children with normal peripheral white blood cell counts were used as the normal control group. The plasma concentration of G-CSF, GM-CSF were analyzed by ELISA. The G-CSFr and GM-CSFr on the peripheral granulocytes were analyzed by a quantitative flow cytometric assay and QuantiBRITE, and the quantitative changes of receptors which did not combine with G-CSF and GM-CSF were measured. RESULTS: The total number of leukocytes in KD was similar to normal control group, but the leukocytes increased according to the number of neutrophils. The plasma concentration of G-CSF were decreased similar to normal control group(P=0.133), but that of GM-CSF decreased more than the normal control group(P=0.227). The quantity of G-CSFr, GM-CSFr were revealed to be no less than the normal control(P=0.721, P=0.912). After incubation with excessive G-CSF, the expressed G-CSFr on the neutrophils were decreased in both groups(P=0.554). The quantities of expressions of GM- CSFr on the neutrophil after incubation with the excessive GM-CSF were always increased in both groups(P=0.255). The amount of GM-CSFr of neutrophils are in proportion to total white blood cells (r=0.788, P=0.035), but it wasn't in the case of KD(P=0.644). CONCLUSION: The leukocytosis in KD that mediated by increasing neutrophil was not correlated with the plasma concentrations of G-CSF and GM-CSF, and the amount of expression of G-CSFr and GM-CSFr on granulocyte. It is possible that the reduction of concentration of GM-CSF results by increasing the active GM-CSFr.
Child ; Enzyme-Linked Immunosorbent Assay ; Granulocyte Colony-Stimulating Factor* ; Granulocyte-Macrophage Colony-Stimulating Factor* ; Granulocytes* ; Humans ; Leukocyte Count ; Leukocytes ; Leukocytosis ; Mucocutaneous Lymph Node Syndrome* ; Neutrophils ; Plasma* ; Receptors, Granulocyte Colony-Stimulating Factor ; Receptors, Granulocyte-Macrophage Colony-Stimulating Factor

PURPOSE: Granulocyte-colony stimulating factor(G-CSF) and granulocyte macrophage-colony stimulating factor(GM-CSF) are principal cytokines in granulopoiesis and their physiologic effects are mediated through binding to specific cell surface receptors. Although it is known that the level of serum G-CSF and GM-CSF, and presentation of the receptors are increased in infectious diseases, there have been no studies to find the correlation between the granulopoiesis and leukocytosis. This study was designed to measure G-CSF and GM-CSF in leukocytosis and in control and to demonstrate the possible pathogenesis of granulopoiesis in leukocytosis using quantitative analysis of G- CSF, GM-CSF and their CSFr. METHODS: The plasma levels of G-CSF, GM-CSF of 13 children without leukocytosis and 14 children with leukocytosis were measured. Counts of cell surface G-CSFr and GM-CSFr were measured by combining anti G-CSFr and anti GM-CSFr monoclonal antibodies to their respective receptors by using quantitative flow cytometric assay. RESULTS: There was no significant difference betweeen the plasma concentration of G-CSF and GM-CSF in acute leukocytosis and in the control group. However, levels of G-CSFr in acute leukocytosis decreased significantly compared to the control(P=0.012) and the levels of GM-CSFr in both groups revealed no significant difference. CONCLUSION: Increase in the number of leukocyte in leukocytosis was mediated by increasing the number of neutrophil, and increased plasma concentration of G-CSF may be the cause of neutrophilia. But GM-CSF did not have any influence on leukocytosis.
Antibodies, Monoclonal ; Child* ; Communicable Diseases ; Cytokines ; Granulocyte Colony-Stimulating Factor* ; Granulocyte-Macrophage Colony-Stimulating Factor* ; Granulocytes* ; Humans ; Leukocytes ; Leukocytosis* ; Neutrophils ; Plasma* ; Receptors, Cell Surface ; Receptors, Granulocyte Colony-Stimulating Factor ; Receptors, Granulocyte-Macrophage Colony-Stimulating Factor

No abstract available.
Granulocyte-Macrophage Colony-Stimulating Factor* ; Granulocytes* ; Humans* ; Macrophages* ; Methotrexate*