Kinetics of peg-filgrastim after high-dose chemotherapy and autologous peripheral blood stem cell transplantation.
Peg-filgrastim is a form of G-CSF with a sustained duration of action due to self-limited clearance. We administered 6 mg peg-filgrastim to 18 autograft recipients on day +1 after transplantation for hematologic malignancies. Plasma samples were collected at baseline and during transplantation. Hematopoietic recovery and clinical outcomes were compared to the historical data of 54 patients not receiving G-CSF. Patients receiving peg-filgrastim achieved a serum level of 115 000 pg/ml on day +2, 24 h after drug administration. Drug level maintained a plateau until day +8 and, after day +10, declined concomitantly with myeloid recovery. Patients experienced prompt neutrophil recovery: days +9 and +10 to 500 and 1000 neutrophils per microliter, and 4 days with an absolute neutrophil count <100 cells per microliter. Duration of antibiotic therapy was significantly shortened, but we did not observe significant differences in other end points. In conclusion, peg-filgrastim was well tolerated and efficacious, and hastened myeloid recovery.
Piccirillo
N
N
1Haematology Institute, A Gemelli Hospital, Catholic University, Rome, Italy. n.piccirillo@rm.unicatt.it
De Matteis
S
S
De Vita
S
S
Laurenti
L
L
Chiusolo
P
P
Sorà
F
F
Reddiconto
G
G
d'Onofrio
G
G
Leone
G
G
Sica
S
S
D000293:Adolescent; D000328:Adult; D003131:Combined Modality Therapy; D005260:Female; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics*; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000628:therapy; D006801:Humans; D018655:Lymphocyte Count; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000166:cytology; D036102:Peripheral Blood Stem Cell Transplantation; D010976:Platelet Count; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics*; D011994:Recombinant Proteins; D020127:Recovery of Function / Q000276:immunology; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D011092:Polyethylene Glycols; D000069585:Filgrastim