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Comparison between standard and high dose of G-CSF for mobilization of hematopoietic progenitors cells in patients and healthy donors. Transfus Med Rev 2022; 36:159-163. [DOI: 10.1016/j.tmrv.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/22/2022] [Accepted: 06/07/2022] [Indexed: 11/23/2022]
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Wu SC, Rau CS, Kuo PJ, Shih FY, Lin HP, Wu YC, Hsieh TM, Liu HT, Hsieh CH. Profiling the Expression of Circulating Acute-Phase Proteins, Cytokines, and Checkpoint Proteins in Patients with Severe Trauma: A Pilot Study. J Inflamm Res 2021; 14:3739-3753. [PMID: 34393495 PMCID: PMC8354739 DOI: 10.2147/jir.s324056] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 07/28/2021] [Indexed: 01/20/2023] Open
Abstract
Purpose Severe trauma may lead to the systemic release of inflammatory mediators into the circulation with profound acute-phase responses; however, the understanding of the expression of these mediators remains limited. This study aimed to characterize the alterations in the expression of circulating acute-phase proteins, cytokines, and checkpoint proteins in patients with severe trauma injuries. Patients and Methods The study population included trauma patients in the intensive care unit (ICU) with an injury severity score equal to or greater than 16 and who had used a ventilator for 48 hours. A total of 12 female and 28 male patients were recruited for the study; six patients died and 34 survived. Blood samples collected at acute stages were compared with those drawn at the subacute stage, the time when the patients were discharged from the ICU, or before the discharge of the patients from the hospital. Results The study identified that the expression of acute-phase proteins, such as alpha-1-acid glycoprotein and C-reactive protein, and cytokines, including granulocyte colony-stimulating factor, interleukin-6, and interleukin-1 receptor antagonist, was elevated in the circulation after severe trauma. In contrast, the levels of acute-phase proteins, such as alpha-2-macroglobulin, serum amyloid P, and von Willebrand factor, and cytokines, including interleukin-4 and interferon gamma-induced protein 10, were reduced. However, there were no significant differences in the expression of checkpoint proteins in the circulation. Conclusion The dysregulated proteins identified in this study may serve as potential therapeutic targets or biomarkers for treating patients with severe trauma. However, the related biological functions of these dysregulated factors require further investigation to validate their functions.
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Affiliation(s)
- Shao-Chun Wu
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Cheng-Shyuan Rau
- Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Pao-Jen Kuo
- Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Fu-Yuan Shih
- Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hui-Ping Lin
- Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yi-Chan Wu
- Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ting-Min Hsieh
- Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hang-Tsung Liu
- Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ching-Hua Hsieh
- Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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Soares JCS, Cavalcanti IDL, Vasconcelos JLDA. Can biosimilar products be interchangeable? Pharmaceutical perspective in the implementation of biosimilars in oncology. J Oncol Pharm Pract 2021; 27:1491-1502. [PMID: 33990164 DOI: 10.1177/10781552211016099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the safety in the interchangeability of biosimilar products approved for cancer treatment from a pharmaceutical perspective. METHODS A literature review was carried out using the descriptors "Biosimilar", "Oncology Therapy", "Interchangeable drugs" and "Biological Products", in the Sciencedirect, MEDLINE, and CAPLUS databases. RESULTS Fifty-one articles were selected, which addressed the importance of establishing standards that prove the efficacy and safety of biosimilars with reference products, as well as the growing interest of the pharmaceutical industry in the development of biosimilars and the impact on costs and changes in the perspective of the treatment of cancer patients. CONCLUSIONS As they are large and complex molecules, it is impossible to obtain identical copies of their reference products, which generates conflicts and concerns on the part of the pharmaceutical class regarding the safety in the interchangeability of these products, highlighting the importance of pharmacovigilance in this process.
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Miller ES, Apple CG, Kannan KB, Funk ZM, Efron PA, Mohr AM. The effects of selective beta-adrenergic blockade on bone marrow dysfunction following severe trauma and chronic stress. Am J Surg 2020; 220:1312-1318. [PMID: 32741547 DOI: 10.1016/j.amjsurg.2020.06.058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 04/19/2020] [Accepted: 06/25/2020] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Propranolol has been shown to improve erythroid progenitor cell growth and anemia following trauma and this study sought to investigate the mechanisms involved by evaluating the effects of selective beta blockade. METHODS Male Sprague-Dawley rats were subjected to lung contusion, hemorrhagic shock and chronic stress (LCHS/CS) ± daily selective beta-1, beta-2, or beta-3 blockade (B1B, B2B, B3B). Bone marrow cellularity and growth of erythroid progenitor colonies, hemoglobin, plasma granulocyte colony-stimulating factor (G-CSF), hematopoietic progenitor cell mobilization, and daily weight were assessed. RESULTS Selective beta-2 and beta-3 blockade improved bone marrow cellularity, erythroid progenitor colony growth and hemoglobin levels, while decreasing plasma G-CSF, progenitor cell mobilization and weight loss following LCHS/CS. CONCLUSIONS Attenuating the neuroendocrine stress response with the use of selective beta-2 and 3 adrenergic blockade may be an alternative to improve bone marrow erythroid function following trauma.
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Affiliation(s)
- Elizabeth S Miller
- University of Florida Health, Department of Surgery and Sepsis and Critical Illness Research Center, Gainesville, FL, USA.
| | - Camille G Apple
- University of Florida Health, Department of Surgery and Sepsis and Critical Illness Research Center, Gainesville, FL, USA.
| | - Kolenkode B Kannan
- University of Florida Health, Department of Surgery and Sepsis and Critical Illness Research Center, Gainesville, FL, USA.
| | - Zackary M Funk
- University of Florida, College of Medicine, Gainesville, FL, USA.
| | - Philip A Efron
- University of Florida Health, Department of Surgery and Sepsis and Critical Illness Research Center, Gainesville, FL, USA.
| | - Alicia M Mohr
- University of Florida Health, Department of Surgery and Sepsis and Critical Illness Research Center, Gainesville, FL, USA.
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Miller ES, Loftus TJ, Kannan KB, Plazas JM, Efron PA, Mohr AM. Systemic Regulation of Bone Marrow Stromal Cytokines After Severe Trauma. J Surg Res 2019; 243:220-228. [PMID: 31207479 DOI: 10.1016/j.jss.2019.05.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 04/03/2019] [Accepted: 05/21/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Traumatic injury generates a prolonged hypercatecholamine state that is associated with reduced growth of bone marrow erythroid progenitors mediated by the bone marrow stroma. The bone marrow stroma is made up of many cells including fibroblasts, which respond to inflammatory stimuli and alter the cytokine profile. We hypothesized that trauma plasma would increase bone marrow stromal fibroblast expression of interleukin-6 (IL-6), granulocyte colony-stimulating factor (G-CSF), erythropoietin (EPO), stem cell factor (SCF), and activation of nuclear factor kappa-light-chain-enhancer of activated B cells and correlate with injury severity and anemia. MATERIALS AND METHODS Plasma from 15 trauma patients was cultured with bone marrow fibroblast cells and compared with that from healthy volunteers. At 6, 24, and 48 h, the expression of IL-6, G-CSF, EPO, SCF, and the activation of nuclear factor kappa-light-chain-enhancer of activated B cells were measured using quantitative polymerase chain reaction. The influence of trauma plasma on cytokine expression was further stratified by injury severity score (ISS). RESULTS The average hemoglobin significantly decreased from admission to discharge (10.7 ± 2.5 to 9.2 ± 1.1 g/dL, P < 0.04). The discharge hemoglobin significantly decreased by 14% from the admission hemoglobin. After 48 h, trauma plasma significantly increased IL-6, G-CSF, and EPO bone marrow fibroblast expression when compared with normal plasma. When stratified by ISS, IL-6, G-CSF, and EPO, bone marrow fibroblast expression was highest in the trauma plasma ISS 27-41 group and was significantly elevated compared with normal plasma. When SCF expression was stratified by ISS, there was a significant increase in expression in ISS 27-41. Higher ISS was also associated with a larger decrease in hemoglobin despite no difference in total blood transfusions. CONCLUSIONS Severe trauma can systemically increase IL-6, G-CSF, and EPO expression in bone marrow stroma. Increased hematopoietic cytokine expression after traumatic injury correlated with a hypercatecholamine state, anemia, and injury severity.
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Affiliation(s)
- Elizabeth S Miller
- Department of Surgery, Sepsis and Critical Illness Research Center, University of Florida Health, Gainesville, Florida
| | - Tyler J Loftus
- Department of Surgery, Sepsis and Critical Illness Research Center, University of Florida Health, Gainesville, Florida
| | - Kolenkode B Kannan
- Department of Surgery, Sepsis and Critical Illness Research Center, University of Florida Health, Gainesville, Florida
| | - Jessica M Plazas
- College of Liberal Arts and Sciences, University of Florida, Gainesville, Florida
| | - Philip A Efron
- Department of Surgery, Sepsis and Critical Illness Research Center, University of Florida Health, Gainesville, Florida
| | - Alicia M Mohr
- Department of Surgery, Sepsis and Critical Illness Research Center, University of Florida Health, Gainesville, Florida.
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Gómez‐De León A, Bugarin‐Estrada E, Colunga‐Pedraza PR, Colunga‐Pedraza JE, Salazar‐Riojas R, Valdés‐Galván M, López‐García YK, López‐Garza M, Gutiérrez‐Aguirre CH, Cantú‐Rodríguez OG, Mancías‐Guerra C, González‐Llano O, Gómez‐Almaguer D. Efficacy of three filgrastim‐intended copies for hematopoietic stem cell mobilization in healthy adult and pediatric donors in Mexico. J Clin Apher 2019; 34:537-544. [DOI: 10.1002/jca.21707] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 03/25/2019] [Accepted: 03/25/2019] [Indexed: 01/03/2023]
Affiliation(s)
- Andrés Gómez‐De León
- Facultad de Medicina y Hospital Universitario “Dr. José Eleuterio González”, Hematology DepartmentUniversidad Autónoma de Nuevo León Monterrey Nuevo León Mexico
| | - Emmanuel Bugarin‐Estrada
- Facultad de Medicina y Hospital Universitario “Dr. José Eleuterio González”, Hematology DepartmentUniversidad Autónoma de Nuevo León Monterrey Nuevo León Mexico
| | - Perla R. Colunga‐Pedraza
- Facultad de Medicina y Hospital Universitario “Dr. José Eleuterio González”, Hematology DepartmentUniversidad Autónoma de Nuevo León Monterrey Nuevo León Mexico
| | - Julia E. Colunga‐Pedraza
- Facultad de Medicina y Hospital Universitario “Dr. José Eleuterio González”, Hematology DepartmentUniversidad Autónoma de Nuevo León Monterrey Nuevo León Mexico
| | - Rosario Salazar‐Riojas
- Facultad de Medicina y Hospital Universitario “Dr. José Eleuterio González”, Hematology DepartmentUniversidad Autónoma de Nuevo León Monterrey Nuevo León Mexico
| | - Mayra Valdés‐Galván
- Facultad de Medicina y Hospital Universitario “Dr. José Eleuterio González”, Hematology DepartmentUniversidad Autónoma de Nuevo León Monterrey Nuevo León Mexico
| | - Yadith K. López‐García
- Facultad de Medicina y Hospital Universitario “Dr. José Eleuterio González”, Hematology DepartmentUniversidad Autónoma de Nuevo León Monterrey Nuevo León Mexico
| | - Mariana López‐Garza
- Facultad de Medicina y Hospital Universitario “Dr. José Eleuterio González”, Hematology DepartmentUniversidad Autónoma de Nuevo León Monterrey Nuevo León Mexico
| | - César H. Gutiérrez‐Aguirre
- Facultad de Medicina y Hospital Universitario “Dr. José Eleuterio González”, Hematology DepartmentUniversidad Autónoma de Nuevo León Monterrey Nuevo León Mexico
| | - Olga G. Cantú‐Rodríguez
- Facultad de Medicina y Hospital Universitario “Dr. José Eleuterio González”, Hematology DepartmentUniversidad Autónoma de Nuevo León Monterrey Nuevo León Mexico
| | - Consuelo Mancías‐Guerra
- Facultad de Medicina y Hospital Universitario “Dr. José Eleuterio González”, Hematology DepartmentUniversidad Autónoma de Nuevo León Monterrey Nuevo León Mexico
| | - Oscar González‐Llano
- Facultad de Medicina y Hospital Universitario “Dr. José Eleuterio González”, Hematology DepartmentUniversidad Autónoma de Nuevo León Monterrey Nuevo León Mexico
| | - David Gómez‐Almaguer
- Facultad de Medicina y Hospital Universitario “Dr. José Eleuterio González”, Hematology DepartmentUniversidad Autónoma de Nuevo León Monterrey Nuevo León Mexico
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Marchesi F, Vacca M, Giannarelli D, Ipsevich F, Pandolfi A, Gumenyuk S, Renzi D, Palombi F, Pisani F, Romano A, Spadea A, Papa E, Canfora M, Pierelli L, Mengarelli A. Lenograstim 5 µg/kg is not superior to biosimilar filgrastim 10 µg/kg in lymphoma patients undergoing peripheral blood stem cell mobilization after chemotherapy: preliminary results from a prospective randomized study. Transfusion 2018; 58:1143-1148. [PMID: 29446445 DOI: 10.1111/trf.14533] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 01/12/2018] [Accepted: 01/14/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Randomized trials comparing chemomobilization efficiency between lenograstim and biosimilar filgrastim are lacking. Our previous retrospective study suggested that lenograstim could be more effective than biosimilar filgrastim when used at the same conventional dosage (5 µg/kg) only in lymphoma patients undergoing peripheral blood stem cell mobilization. We planned a prospective randomized study comparing lenograstim 5 µg/kg with biosimilar filgrastim 10 µg/kg to verify the hypothesis of lenograstim superiority even at half the dosage (stress test). Herein we report data after enrolling 60% of planned patients. STUDY DESIGN AND METHODS From October 2014 to November 2017, a total of 42 of 70 planned patients with lymphoma were randomly assigned to receive lenograstim 5 µg/kg (21) or biosimilar filgrastim 10 µg/kg (21). Patients were stratified according to treatment line at the time of mobilization (1 or ≥2). Primary endpoint was the rate of achievement of the CD34+ cell collection target dose (≥ 4 × 106 /kg). An improvement by 23% was expected to validate the hypothesis of lenograstim superiority. RESULTS The two cohorts were balanced for all the baseline features. We observed an identical rate of patients able to reach the targeted CD34+ cell dose and of mobilization failures (90.4 and 4.8% in both cohorts) and a perfect equivalence in any of the secondary collection outcomes. The hypothesis of lenograstim superiority was not corroborated at interim analysis. CONCLUSION Lenograstim at conventional dosage has failed to demonstrate its superiority over biosimilar filgrastim at double the dosage at interim analysis in their first head-to-head trial.
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Affiliation(s)
| | - Michele Vacca
- Immuno-Transfusional Medicine, Leukapheresis and Cellular Therapy Unit, S. Camillo-Forlanini Hospital, Rome, Italy
| | - Diana Giannarelli
- Biostatistics Unit, Scientific Direction, IRCCS Regina Elena National Cancer Institute, Regina Elena National Cancer Institute
| | - Francesco Ipsevich
- Immuno-Transfusional Medicine, Leukapheresis and Cellular Therapy Unit, S. Camillo-Forlanini Hospital, Rome, Italy
| | - Annino Pandolfi
- Immuno-Transfusional Medicine, Leukapheresis and Cellular Therapy Unit, S. Camillo-Forlanini Hospital, Rome, Italy
| | | | | | | | | | | | | | - Elena Papa
- Hematology and Stem Cell Transplant Unit
| | - Marco Canfora
- Biostatistics Unit, Scientific Direction, IRCCS Regina Elena National Cancer Institute, Regina Elena National Cancer Institute
| | - Luca Pierelli
- Immuno-Transfusional Medicine, Leukapheresis and Cellular Therapy Unit, S. Camillo-Forlanini Hospital, Rome, Italy
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