Effect of recombinant human granulocyte colony stimulating factor (lenograstim) on chemotherapy induced neutropenia in patients with urothelial cancer.
BACKGROUND
A multicenter cooperative study to evaluate clinical usefulness of recombinant human granulocyte colony stimulating factor (rG-CSF; lenograstim) in the treatment of neutropenia associated with cancer chemotherapy was conducted in patients with urothelial cancer.


METHODS
Therapeutic responses were compared within each patient between the observation and study treatment phases.


RESULTS
Treatment with rG-CSF raised the nadir of the neutrophil count (343 to 3015/mm3), reduced the duration of neutropenia (6.2 to 0.4 days) and hastened recovery from the neutropenic state (23.5 to 5.5 days). Febrile neutropenia was encountered in 12 patients during the observation phase alone and in only one patient during the study treatment phase alone. The mean duration of febrile neutropenia was also shortened (0.39 to 0.12 days). In addition, the duration of antibiotic therapy was significantly reduced during treatment. The percentage of patients completing the chemotherapeutic regimens of combination M-VAC therapy was markedly increased to 81.0% as a result of rG-CSF therapy compared with 44.8% in the observation phase. Adverse reactions were observed in four patients and abnormal laboratory values were found in nine patients. None of these adverse events was of a serious nature.


CONCLUSIONS
These results indicate that rG-CSF is a useful drug for the treatment of neutropenia associated with chemotherapy in urothelial cancer.
Kotake
T
T
Department of Urology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Japan.
Usami
M
M
Miki
T
T
Togashi
M
M
Akaza
H
H
Kubota
Y
Y
Matsumura
Y
Y
D000276:Adjuvants, Immunologic / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001424:Bacterial Infections / Q000453:epidemiology; D002945:Cisplatin / Q000009:adverse effects; D004317:Doxorubicin / Q000009:adverse effects; D005260:Female; D005334:Fever / Q000139:chemically induced / Q000453:epidemiology; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage*; D006801:Humans; D015994:Incidence; D000078224:Lenograstim; D007958:Leukocyte Count; D008297:Male; D008727:Methotrexate / Q000009:adverse effects; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced / Q000188:drug therapy* / Q000401:mortality; D009504:Neutrophils / Q000166:cytology; D011994:Recombinant Proteins / Q000008:administration & dosage; D013280:Stomatitis / Q000139:chemically induced / Q000453:epidemiology; D016019:Survival Analysis; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000401:mortality; D019459:Urothelium / Q000473:pathology; D014747:Vinblastine / Q000009:adverse effects
D000276:Adjuvants, Immunologic; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D014747:Vinblastine; D000078224:Lenograstim; D004317:Doxorubicin; D002945:Cisplatin; D008727:Methotrexate