Ewa Sierko, Marek Z. Wojtukiewicz

Pelfigrastim - nowe podejście do zapobiegania neutropenii

Pegfilgrastim - a new approach to prophylaxis of neutropenia. Neutrophilic granulocytes (neutrophils) are produced in bone marrow. They play an important role in the defensive processes against infection, such as phagocytosis of microorganisms, oxidative stress, etc. Decreased count of neutrophil is the most common complication of chemotherapy. It also accompanies radiotherapy. Neutropenia is associated with an increase of incidence of infections, which are the cause of death of about 30-40% of cancer patients. For many years granulocyte colony stimulating factors (G-CSF) have been administered in the treatment and prophylaxis of this complication in patients with cancer undergoing cytotoxic therapy. Recently a newly synthesized form of rmetHuG- CSF (filgrastim) - pegylated filgrastim (pegfilgrastim), was introduced to the clinic. Its half-time is 48 hours comparing to 3,5 hours for filgrastim. Therapeutic concentration of pegfilgrastim is maintained in blood persists during the entire period of neutropenia. The increase in the neutrophil count is associated with the decrease in pegfilgrastim concentration in blood, which is due to the neutrophil clereance of pegfilgrastim (the main route of its elimination). In clinical studies pegfilgrastim was documented to decrease the incidence of febrile neutropenia, the need of hospitalization as well as the amount of intravenous antibiotics. Pegfilgrastim is administered every 3 weeks, 24 hours after completion of chemotherapy. Safety profile and effectiveness of pegfilgrastim and the costs of treatment are similar to filgrastim.