Use of filgrastim for stem cell mobilisation and transplantation in high-dose cancer chemotherapy.
Myeloablative or high-dose chemotherapy regimens utilise doses that are significantly greater than those used in standard treatments. The neutropenia caused by these high-dose therapies can be associated with an increased incidence of bacterial and fungal infections and remains an important clinical issue among patients with advanced-stage cancers. Filgrastim is approved for stem cell mobilisation in both chemotherapy-treated patients and normal donors. Harvested peripheral blood progenitor cells have been used effectively in allogeneic and autologous transplantation, increasing the speed and extent of neutrophil and platelet recovery. Accelerated haematopoietic recovery is associated with a significantly shorter hospital stay and, therefore, leads to a reduction in treatment costs. The contribution of filgrastim to the acceleration of haematopoietic recovery after peripheral blood progenitor cell transplant has been assessed in a number of prospective clinical trials after high-dose chemotherapy. Controversy remains over whether growth factors should be administered shortly after stem cell infusion or after several days. The recently approved, once-weekly form of filgrastim, pegfilgrastim, has been shown to have efficacy comparable to that of the native molecule and can be expected to enhance patient quality of life through the need for fewer injections. This article will review the role of filgrastim for stem cell mobilisation and transplantation in patients receiving high-dose chemotherapy.
Anderlini
Paolo
P
UT MD Anderson Cancer Center, Houston, Texas 77030-4009, USA.
Champlin
Richard
R
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology* / Q000627:therapeutic use*; D019650:Hematopoietic Stem Cell Mobilization; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy / Q000628:therapy*; D009503:Neutropenia / Q000139:chemically induced / Q000188:drug therapy / Q000517:prevention & control; D011994:Recombinant Proteins / Q000494:pharmacology / Q000627:therapeutic use
D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D000069585:Filgrastim