Search

The most appropriate time for administration was studied based on examination of the total number of leukocytes, differential white blood count, and the number of platelets in 30 cases in which 200 micrograms Romurtide (Nopia) was injected subcutaneously on the day of radiotherapy, 5 times a week, for 2 weeks, totally 10 times because leukopenia was caused during treatment with radiotherapy. It was recognized that the number of leukocytes, mainly neutrophils, increased from 1 week after starting administration of Romurtide to after the completion of administration (2 weeks after administration), except 1 week after completion of administration. The increasing effect in the number of platelets was not recognized, and it had decreased from at the completion of administration to 1 week after the completion of administration of Romurtide. The rate of completion of radiotherapy was 100% without any serious adverse events, but there were 4 cases in which fever was observed. Therefore, it is not very favorable to administer Romurtide immediately after radiation, taking account of the treatment period of radiotherapy. It is also considered that it would be necessary to start radiation after sufficient recovery of the number of leukocytes or increase in their number by using G-CSF preparation in cases in which the leukocyte count has fallen since starting radiation due to the influence of the preceding chemotherapy.

The effectiveness of thrice-weekly injection of Romurutide for leukocytopenia due to radiation therapy was analyzed. Twenty-two patients were randomly divided into two groups. Ten of group A cases were injected 3 times per week 10 times (3 weeks) and 12 of group B cases were injected 5 times per week 10 times (2 weeks). White blood cell counts and neutrophil numbers in group A were almost the same as in group B at day-3 and day-8, and those in group A were more than in group B at day-15 and day-22, although there were no statistical significances. Lymphocyte percentages, monocyte percentages and platelet cell counts between groups showed no differences. Injections were stopped in 3 cases due to fever (2 in group A, 1 in group B). The effects were recognized in nineteen cases (excluding above 3 cases). The effect of this thrice-weekly injection method during the injection period was the same or more than with 5 injections/week, and the period of the former was 50% longer. The 3 weekly injection method is more effective for prophylaxis of leukocytopenia.

Therapeutic efficacy of kanamycin (KM) and clofazimine (CFZ) combined with N2-[(N-acetyl-muramyl)-L-alanyl-D-isoglutaminyl]-N6-stearoyl-L-ly sine, MDP-Lys (L18), against Mycobacterium intracellulare infection induced in mice was studied, based on suppression of incidence of gross lung lesions and bacterial growth at the sites of infection (lungs and spleen), and the following results were obtained. Firstly, KM (0.5 mg) was given sc to mice, daily six times per week in combination (or not) with sc injections of MDP-Lys(18) (0.1 mg) either 1, 3 or 5 times weekly. In this case, KM alone markedly suppressed the incidence of pulmonary gross lesions and the growth of organisms in the lungs and spleen (2-2.5 log-decrease in CFU per organ at week 8) in infected mice. MDP-Lys(18) alone also exhibited similar effect but the efficacy was much lower than that of KM. No synergism was observed for combined use of KM with MDP-Lys(18) in any protocols tested. Secondly, CFZ (0.5 mg) was given to mice by gavage, daily six times per week in combination with or without injections of MDP-Lys(18) (0.1 mg), either 1, 3 or 5 times weekly. In this case, CFZ alone decreased the incidence of gross pulmonary lesions in infected mice and the weaker suppressive effect was noted for MDP-Lys(18) alone. Moreover, CFZ alone suppressed bacterial growth in the lungs and spleen (1.5-2.0 log-decrease in CFU per organ at week 8), while MDP alone failed to cause such a marked reduction in bacterial CFU in the visceral organs.(ABSTRACT TRUNCATED AT 250 WORDS)

Muroctasin, a derivative of MDP, is known to augment the number of WBC via colony-stimulating factor. Muroctasin has been expected to be promising for application to leukopenia caused by anticancer chemotherapy. When WBC decreased to less than or equal to 3,000/mm3 after the 1st course of chemotherapy, 131 patients with lung cancer, who were previously classified by chemotherapy combination, were enrolled in the study and randomized into 3 groups, 200 micrograms (H), 100 micrograms (L) and untreated control (C) groups. The patients were then subcutaneously treated once daily for 6 consecutive days. WBC and its differential count were measured on days 4, 7 and 15 after commencement of the study. WBCs in H and L groups showed greater recovery than in C group. In WBC differential count, the recovery of neutrophil was prominent in muroctasin-treated groups. A portion of immature neutrophil in bone marrow was also increased by muroctasin treatment. In the present study, the usefulness of muroctasin in leukopenia was indicated when administered at dosages of 200 micrograms for 6 days.