Clinical observationof pegylated recombinant human granulocyte colony stimulating factor in salvage therapy for ;degree Ⅲ neutropenia caused by radiother apy and chemotherapy in synchr onism

doi:10.3969/j.issn.1002-7386.2014.22.006

Abstract：Objective To investigate the therapeutic effect and adverse reaction of salvage therapy of pegylated recombinant human granulocyte colony stimulating factor( PEG-rhG-CSF) on degree Ⅲ neutropenia induced by radiotherapy and chemotherapy in synchronism in order to provide basis for reasonable application of PEG-rhG-CSF in clinic.Methods The data about 105 patients with degree Ⅲ neutropenia caused by radiotherapy and chemotherapy in synchronism were analyzed.The experimental groups included group PEG50 ( n=38),group PEG100 ( n =26),group PEG+R ( n =21). The patients in the three groups were given respectively with a single injection of PEG -rhG-CSF 50μg/kg,a single injection of PEG-rhG-CSF 100μg/kg,a single injection of PEG-rhG-CSF 50μg/kg plus multiple injections of rhG-CSF 5μg· kg-1 · d-1 , until the absolute neutrophil count ( ANC) ≥2.0 ×109/L.The 20 patients in control group received multiple injections of rhG-CSF 5μg· kg-1 · d-1 ,untill ANC≥2.0 ×109/L.The time-neutrophil proliferation rate,time-ANC,the time of symptom relief,the incidence of drug adverse reaction were statistically analyzed .Rseults The time-neutrophil proliferation rate , time-ANC in experimental group were significantly increased, as compared with those in control group ( P <0.05 ) .The starting time of clinical effect in experimental groups began during 12 ~24 hours, and the symptoms of neutropenia were improved about 24 hours.There were no significant differences in the time-neutrophil proliferation rate and time-ANC between the PEG50 group and PEG+R group ( P >0.05).There was no significant difference in the time of symptom relief between experimental group and control group ( P >0.05 ) .Conclusion The recommended dose of PEG-rhG-CSF in salvage treatment of degreeⅢneutropenia is single subcutaneous injection of 50μg/kg,its clinical effects start after 12~24 hours,and it need not to reinforce rhG-CSF if ANC has no obvious enhancement during this period .