Bedell Cindi
Clin J Oncol Nurs. 2003 Jan-Feb;7(1):55-6, 63-4. doi: 10.1188/03.CJON.55-56.
Many chemotherapy regimens cause myelosuppression, which can result in febrile neutropenia and potentially lead to serious infections. The risk of neutropenia and its complications can be reduced with filgrastim, a granulocyte-colony-stimulating factor. Filgrastim is safe and effective, but it is cleared rapidly from the body (predominantly through the kidneys) and requires daily administration for up to 14 days. A pegylated form of filgrastim, pegfilgrastim, has been developed by attaching a polyethylene glycol molecule to filgrastim. Pegfilgrastim has an extended circulation half-life and self-regulating, patient-specific pharmacokinetics, making it possible to give the treatment as a single dose once per chemotherapy cycle. Clinical trials have shown that a single, subcutaneous dose of pegfilgrastim is as safe and effective as daily filgrastim injections in patients treated with myelosuppressive chemotherapy. In addition, a single, 6 mg fixed dose of pegfilgrastim per chemotherapy cycle is sufficient in adult patients, regardless of their body weight, making pegfilgrastim a simple, effective, and well-tolerated option for managing chemotherapy-induced neutropenia.
许多化疗方案会导致骨髓抑制,进而可能引发发热性中性粒细胞减少症,并有可能导致严重感染。使用粒细胞集落刺激因子非格司亭可降低中性粒细胞减少症及其并发症的风险。非格司亭安全有效,但会迅速从体内清除(主要通过肾脏),需要每天给药,持续14天。通过将聚乙二醇分子连接到非格司亭上,已开发出一种聚乙二醇化形式的非格司亭,即聚乙二醇非格司亭。聚乙二醇非格司亭具有延长的循环半衰期和自我调节、因人而异的药代动力学特性,使得在每个化疗周期只需单次给药即可进行治疗。临床试验表明,对于接受骨髓抑制性化疗的患者,单次皮下注射聚乙二醇非格司亭与每日注射非格司亭一样安全有效。此外,每个化疗周期单次给予固定剂量6mg的聚乙二醇非格司亭对成年患者就足够有效,无论其体重如何,这使得聚乙二醇非格司亭成为治疗化疗引起的中性粒细胞减少症的一种简单、有效且耐受性良好的选择。