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Effect of granulocyte colony-stimulating factor on neutropenia and associated morbidity due to chemotherapy for transitional-cell carcinoma of the urothelium.
- Source :
-
The New England journal of medicine [N Engl J Med] 1988 Jun 02; Vol. 318 (22), pp. 1414-22. - Publication Year :
- 1988
-
Abstract
- We evaluated the ability of human recombinant granulocyte colony-stimulating factor (rhG-CSF) to prevent chemotherapy-induced neutropenia or to accelerate recovery from this complication and thus allow patients to receive full doses of antineoplastic agents on time, according to protocol design. Twenty-seven patients with transitional-cell carcinoma of the urothelium who were undergoing treatment with methotrexate, doxorubicin, vinblastine, and cisplatin were given rhG-CSF (up to 60 micrograms per kilogram of body weight per day) before their first cycle of combination chemotherapy, during the first cycle, or at both points. Treatment with rhG-CSF before chemotherapy resulted in a dose-dependent increase in the absolute neutrophil count. Treatment with rhG-CSF after chemotherapy significantly reduced the number of days (91 percent) per patient on which the absolute neutrophil count was 1000 per microliter or less (P = 0.0039), reduced the number of days (1 vs. 35) on which antibiotics were used to treat fever and neutropenia, and significantly increased the percentage (100 vs. 29 percent) of patients qualified to receive planned chemotherapy on day 14 of the treatment cycle (P = 0.0015). In addition, the incidence of mucositis was significantly decreased (11 vs. 44 percent, P = 0.041), as was its severity. These findings demonstrate that rhG-CSF is a potent stimulus of normal neutrophil proliferation and maturation. In addition, its administration can reduce both the hematopoietic and oral toxicity of chemotherapy.
- Subjects :
- Adult
Aged
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Cisplatin administration & dosage
Colony-Stimulating Factors administration & dosage
Dose-Response Relationship, Drug
Doxorubicin administration & dosage
Drug Administration Schedule
Drug Tolerance
Female
Granulocyte Colony-Stimulating Factor
Humans
Leukocyte Count
Male
Methotrexate administration & dosage
Middle Aged
Neutropenia therapy
Neutrophils
Recombinant Proteins administration & dosage
Recombinant Proteins therapeutic use
Vinblastine administration & dosage
Agranulocytosis prevention & control
Antineoplastic Combined Chemotherapy Protocols adverse effects
Carcinoma, Transitional Cell drug therapy
Colony-Stimulating Factors therapeutic use
Neutropenia prevention & control
Urinary Bladder Neoplasms drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 0028-4793
- Volume :
- 318
- Issue :
- 22
- Database :
- MEDLINE
- Journal :
- The New England journal of medicine
- Publication Type :
- Academic Journal
- Accession number :
- 2452983
- Full Text :
- https://doi.org/10.1056/NEJM198806023182202