Anderlini Paolo, Champlin Richard
UT MD Anderson Cancer Center, Houston, Texas 77030-4009, USA.
Drugs. 2002;62 Suppl 1:79-88. doi: 10.2165/00003495-200262001-00006.
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.
清髓性或高剂量化疗方案所使用的剂量显著高于标准治疗中的剂量。这些高剂量疗法导致的中性粒细胞减少可能与细菌和真菌感染发生率增加有关，并且在晚期癌症患者中仍然是一个重要的临床问题。非格司亭已被批准用于化疗患者和正常供体的干细胞动员。采集的外周血祖细胞已有效地用于异基因和自体移植，提高了中性粒细胞和血小板恢复的速度和程度。加速造血恢复与显著缩短住院时间相关，因此可降低治疗成本。在多项高剂量化疗后的前瞻性临床试验中，已评估了非格司亭对外周血祖细胞移植后造血恢复加速的作用。对于生长因子应在干细胞输注后不久还是几天后给药仍存在争议。最近获批的每周一次的非格司亭聚乙二醇化非格司亭，已显示出与天然分子相当的疗效，并且预计通过减少注射次数可提高患者生活质量。本文将综述非格司亭在接受高剂量化疗患者的干细胞动员和移植中的作用。
