급성 림프구성 백혈병 환아에서 항암화학요법 후 사용되는 Filgrastim과 Lenograstim의 효과 비교

Abstract

Granulocyte colony-stimulating factor(G-CSF) has been incorporated into the treatment regimens of many patients in an effort to decrease the risk of neutropenic complications, including febrile neutropenia after myelosuppressive chemotherapy regimens. In doing so, it could significantly reduce incidence and severity of neutropenic infection, thus decreasing morbidity and health care expenditure. Two formulations of recombinant human G-CSF(rhG-CSF), one non-glycosylated(filgrastim) and one glycosylated(lenograstim), are available. This study was undertaken to compare the hematologic effects of filgrastim and lenograstim after chemotherapy in children with acute lymphoblastic leukemia(ALL). From September 2005 to August 2006, 157 cases(87 filgratim, 70 lenograstim) with acute lymphoblastic leukemia who had received G-CSF after chemotherapy at Seoul National University Hospital department of pediatrics were studied. We retrospectively analyzed the duration of G-CSF treatment, neutropenia and the frequency of neutropenic fever, IV antibiotic treatment. There was no significant difference in duration of GCSF treatment(5.3±3.7 vs 4.6±3.1 days, filgrastim vs lenograstim, Mean±SD), time to absolute neutrophil count(ANC) recovery to above 500/mm3(5.1±3.7 vs 4.7±3.0 days), febrile days(2.3±1.6 vs 2.3±1.5 days), and duration of antibiotic treatment(6.0±3.0 vs 5.7±2.7 days) Also, frequency of neutropenic fever and antibiotic treatment were similar in both groups. In summary, in terms of their clinical effect on neutropenia, the two G-CSF preparations appeared to have identical activity. A large-scale randomized prospective studies are necessary to confirm and evaluate the efficacy of two types of G-CSF.