Ariyoshi Y
Dept. of Hematology and Chemotherapy, Aichi Cancer Center.
Gan To Kagaku Ryoho. 1993 Mar;20(4):541-9.
Colony-stimulating factors (CSFs) are glycoprotein growth factors that influence the proliferation and differentiation of hematopoietic progenitor cells. Among CFSs granulocyte colony-stimulating factor (G-CSF) is thought to be major stimulator of production of human neutrophilic granulocyte. G-CSF have recently moved from the basic research to the clinical use and have been suggested to have important roles in cancer management. Today two kinds of recombinant G-CSF which have similar specific activity are commercially available, one is derived from ovarian cells of Chinese hamster and the other from E. coli. (Variant type of E. coli is now in trial.) Difference of these two is whether carbohydrate chain primarily seen in molecule of natural form is contained or not. In this report recombinant product of G-CSF for the clinical use is introduced. Preclinical study with recombinant G-CSF have suggested that it would stimulate granulocyte production in cancer patients with myelosuppression due to chemotherapy. Thus, after evaluation of toxicities and possible efficacy recombinant G-CSF has been introduced into phase II trial for the prevention of chemotherapy-induced neutropenia in various cancers. In this setting 2 micrograms/kg of subcutaneous administration for 14 days after aggressive chemotherapy was suggested to be optimal and to be acceptable for toxicities including bone pain or headache. In conclusion recombinant G-CSF is thought to be very useful drug for reduction of nadir of cancer chemotherapy-induced neutropenia and shortening of period of neutropenia.
集落刺激因子(CSFs)是一类糖蛋白生长因子,可影响造血祖细胞的增殖和分化。在集落刺激因子中,粒细胞集落刺激因子(G-CSF)被认为是人类嗜中性粒细胞生成的主要刺激因子。G-CSF最近已从基础研究进入临床应用,并被认为在癌症治疗中具有重要作用。如今,有两种具有相似比活性的重组G-CSF可供商业使用,一种来源于中国仓鼠的卵巢细胞,另一种来源于大肠杆菌。(大肠杆菌的变异型目前正在试验中。)这两种产品的区别在于是否含有天然形式分子中主要可见的糖链。在本报告中,介绍了临床使用的G-CSF重组产品。重组G-CSF的临床前研究表明,它可刺激因化疗导致骨髓抑制的癌症患者的粒细胞生成。因此,在评估毒性和可能的疗效后,重组G-CSF已被引入II期试验,用于预防各种癌症化疗引起的中性粒细胞减少。在这种情况下,建议在强化化疗后皮下注射2微克/千克,持续14天,这是最佳方案,且对包括骨痛或头痛在内的毒性是可接受的。总之,重组G-CSF被认为是一种非常有用的药物,可降低癌症化疗引起的中性粒细胞减少的最低点,并缩短中性粒细胞减少的持续时间。