Cost-effective G-CSF therapy strategies for cyclical neutropenia: mathematical modelling based hypotheses.
Using computer simulations of a mathematical model for the regulation of stem cell and neutrophil production in dogs, we have studied the efficacy of four different treatment protocols for cyclical neutropenia involving granulocyte colony stimulating factor (G-CSF). The first treatment scheme is based on the bifurcation analysis of the mathematical model and proposes a daily, phase-dependent, protocol. The second involves alternate day administration of G-CSF. The third triggers G-CSF administration whenever neutrophil levels fall below a predetermined level, and the fourth one follows a random administration protocol. The computer simulations predict that clinically desirable results can be achieved with the three last methods, using far less G-CSF than would be needed with the standard daily treatment. If the results of this modelling are borne out clinically, they will entail a considerable financial savings for patients.
Foley
Catherine
C
Department of Mathematics and Centre for Nonlinear Dynamics, McGill University, 3655 Promenade Sir William Osler, Montreal, QC, Canada, H3G 1Y6. foley@math.mcgill.ca
Bernard
Samuel
S
Mackey
Michael C
MC
D000818:Animals; D003198:Computer Simulation; D003362:Cost-Benefit Analysis; D004285:Dogs; D004334:Drug Administration Schedule; D016527:Drug Costs; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage* / Q000191:economics / Q000627:therapeutic use; D008954:Models, Biological; D009503:Neutropenia / Q000188:drug therapy* / Q000191:economics
D016179:Granulocyte Colony-Stimulating Factor