1
|
Mazzola J, Hennon P, Peine K, Siedlecki SL. Effect of Loratadine for Pegfilgrastim-Induced Bone Pain. Pain Manag Nurs 2024; 25:e132-e137. [PMID: 38216368 DOI: 10.1016/j.pmn.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/30/2023] [Accepted: 12/19/2023] [Indexed: 01/14/2024]
Abstract
AIMS Breast cancer patients on chemotherapy who receive pegfilgrastim to prevent neutropenia may experience severe bone pain as a side effect. Traditional treatment recommendations include nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, opioids, and/or antihistamine use. However, little research was found comparing these interventions. The study aim was to address the gaps in literature and to explore the use of and perceived effectiveness of loratadine versus acetaminophen or NSAIDs in women with breast cancer treated with pegfilgrastim. This study also sought to understand how patients became aware of loratadine or other treatments for management of bone pain. DESIGN/METHODS This cross-sectional study used survey methods to collect data from 66 adult female breast cancer patients receiving chemotherapy with pegfilgrastim. RESULTS The incidence of bone pain was 45% (n = 30) in our sample, but more than half (n = 45; 69%) of the women took either acetaminophen, NSAIDs, or loratadine alone or in combination to prevent bone pain. All medication were rated as effective by patients, with acetaminophen slightly more effective than loratadine, and loratadine more effective than NSAIDs. CONCLUSIONS Acetaminophen, NSAIDs, and loratadine are easily available and inexpensive. However, unlike acetaminophen and NSAIDs, loratadine is dosed once a day and well tolerated with minimal adverse effects. CLINICAL IMPLICATIONS Randomized controlled trials are needed to adequately assess the effectiveness of all three medication options. Because little is known about optimal use of any of these medications for pegfilgrastim-induced bone pain, it is also important to identify the optimal time to initiate treatment and ideal treatment duration.
Collapse
Affiliation(s)
| | | | - Kellie Peine
- Care Coordinator, Taussig Institute, Cleveland Clinic, Beachwood, Ohio
| | - Sandra L Siedlecki
- Senior Nurse Scientist, Office of Nursing Research and Innovation, Cleveland Clinic, Cleveland, Ohio
| |
Collapse
|
2
|
125I brachytherapy: a useful treatment to control painful osteoblastic bone metastases. Clin Transl Oncol 2022; 25:1297-1306. [PMID: 36472748 PMCID: PMC10119221 DOI: 10.1007/s12094-022-03025-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022]
Abstract
Abstract
Backgrounds
125I brachytherapy is effective in relieving cancer pain due to osteolytic bone metastases. However, fewer studies focused on painful osteoblastic bone metastases (OBMs), we conducted a retrospective study to evaluate the efficacy of 125I brachytherapy for the treatment of painful OBMs.
Methods
From April 2017 to April 2019, clinical data of a total of 65 patients with OBMs who underwent CT/cone beam CT -guided 125I brachytherapy were collected and analyzed. The primary study endpoints were technical success, relief of pain (RoP), and quality of life (QoL). The secondary study endpoints were treatment-related complications, local tumor control (LCR), and overall survival (OS). The logistic regression analysis was performed to predict RoP.
Results
Technical success rate was 100%. Visual analog scale scores and daily morphine consumption continuously decreased significantly at 2 weeks, 6 weeks, and 10 weeks (all P < 0.05). The RoP at 6 weeks was 84.62%. QoL presented improvement at 6 and 10 weeks. Only minor complications occurred in 12 patients (18.46%). LCR was 93.85% at 10 weeks. The OS was 29.80 months. Two factors were significantly associated with the RoP: max diameter (MD, < 3 cm vs. ≥ 3 cm, P = 0.019) and serum levels of bone alkaline phosphatase (B-ALP, ≥ 100 U/L vs. < 100 U/L, P = 0.016).
Conclusions
125I brachytherapy is an effective treatment in relieving painful OBMs and improving patients’ QoL.
Collapse
|
3
|
Chen LN, Montemayor-Garcia C, West-Mitchell KA, Cantilena CC. Increased serum pro-B-type natriuretic peptide in hematopoietic progenitor cell donors stimulated with G-CSF. J Clin Apher 2022; 37:354-359. [PMID: 35301751 PMCID: PMC9378357 DOI: 10.1002/jca.21979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 02/10/2022] [Accepted: 02/11/2022] [Indexed: 11/07/2022]
Abstract
Hematopoietic stem cells (HPCs) donors mobilized by granulocyte-colony-stimulating factor (G-CSF) can develop various signs and symptoms. proBNP (pro-B-type natriuretic peptide) is a serum marker of heart failure. A donor who developed severe adverse reactions after G-CSF mobilization was found to have high serum proBNP levels. We followed additional donors who received identical mobilization regimen to investigate the prevalence of this phenomenon. Eighteen healthy donors underwent a mobilization regimen of 10 μg/Kg G-CSF daily for 5 days prior to allogeneic HPC collection using Spectra Optia between January 2016 and February 2017 were included in this study. Serum proBNP levels were measured before and after G-CSF stimulation and immediately after apheresis. Apheresis collection parameters and other laboratory results were also reviewed. The majority of donors (86.7%) had post-G-CSF elevation of serum proBNP. Seven of those had elevated proBNP above upper normal range (124 pg/ml). The subgroup of donors with normal proBNP is younger (median age of 37 vs 42 years), with majority being male (90.9% vs 28.6%) and with smaller processed blood volume (2.2 vs 3 × total blood volume). This case series demonstrates an increase of serum proBNP can be common in HPC donors stimulated with 5 days of 10 mcg/kg G-CSF. This is an adverse reaction that has not been described before. The temporary elevation of proBNP in these donors is not associated with ventricular dysfunction of the heart. The risk factors for marked elevation of proBNP post-G-CSF should be further investigated.
Collapse
Affiliation(s)
- Leonard N Chen
- Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
| | | | | | - Cathy C Cantilena
- Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
| |
Collapse
|
4
|
Zhang X, Chen Y, Zhang C, Zhang X, Xia T, Han J, Song S, Xu C, Chen F. Effects of icariin on the fracture healing in young and old rats and its mechanism. PHARMACEUTICAL BIOLOGY 2021; 59:1245-1255. [PMID: 34511043 PMCID: PMC8439244 DOI: 10.1080/13880209.2021.1972121] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 07/06/2021] [Accepted: 08/19/2021] [Indexed: 06/13/2023]
Abstract
CONTEXT Icariin has attracted increasing attention because of its wide variety of pharmacological effects. OBJECTIVE This study investigates whether icariin could promote fracture healing in young and old rats and its mechanisms. MATERIALS AND METHODS A Wistar rat model for the tibia fracture in relatively young and old rats, respectively, was established. The rats were divided into four groups: model group, L-icariin (50 mg/kg icariin), M-icariin (100 mg/kg icariin) and H-icariin (200 mg/kg icariin), and intragastric administration of icariin was performed for 10 days or 20 days. In addition, isolated and cultured rat bone mesenchymal stem cells (rBMSCs) from young and old rats were cultured with 5% and 20% of icariin-containing serum, respectively, then cell viability and alkaline phosphatase (ALP) activity were measured. RESULTS Icariin administration induced the expression of Runx2, Osterix, BMP-2, p-Smad5 and osteocalcin secretion (young rats: model: 2.50 ± 0.71; L-icariin: 10.10 ± 1.55; M-icariin: 24.95 ± 2.19; H-icariin: 36.80 ± 2.26; old rats: model: 1.55 ± 0.49; L-icariin:6.55 ± 0.50; M-icariin: 15.00 ± 0.85; H-icariin:20.50 ± 2.27) at the fracture site, and increased the levels of bone formation markers (OC, BAP, NTX-1 and CTX-1) in a dose-dependent manner. In vitro, icariin treatment promoted rBMSC viability, increased ALP activity and the expression of BMP-2/Smad5/Runx2 pathway proteins. DISCUSSION AND CONCLUSIONS Icariin may accelerate fracture healing by activating the BMP-2/Smad5/Runx2 pathway in relatively young and old rats. The research on the mechanism of icariin to promote fracture healing can provide a theoretical basis for the clinical application and promotion of icariin.
Collapse
Affiliation(s)
- Xiaoyun Zhang
- Clinical Medical School, Jiangxi University of Traditional Chinese Medicine, Nanchang, China
- Department of Orthopedics, Ruikang Hospital Affiliated with Guangxi University of Chinese Medicine, Nanning, China
| | - Yueping Chen
- Department of Orthopedics, Ruikang Hospital Affiliated with Guangxi University of Chinese Medicine, Nanning, China
| | - Chi Zhang
- Department of Orthopedics, Ruikang Hospital Affiliated with Guangxi University of Chinese Medicine, Nanning, China
| | - Xuan Zhang
- Department of Orthopedics, Ruikang Hospital Affiliated with Guangxi University of Chinese Medicine, Nanning, China
| | - Tian Xia
- Department of Orthopedics, Ruikang Hospital Affiliated with Guangxi University of Chinese Medicine, Nanning, China
| | - Jie Han
- Department of Orthopedics, Ruikang Hospital Affiliated with Guangxi University of Chinese Medicine, Nanning, China
| | - Shilei Song
- Department of Orthopedics, Ruikang Hospital Affiliated with Guangxi University of Chinese Medicine, Nanning, China
| | - Canhong Xu
- Department of Orthopedics, Ruikang Hospital Affiliated with Guangxi University of Chinese Medicine, Nanning, China
| | - Feng Chen
- Department of Orthopedics, Ruikang Hospital Affiliated with Guangxi University of Chinese Medicine, Nanning, China
| |
Collapse
|
5
|
Zhang XY, Chen YP, Zhang C, Zhang X, Xia T, Han J, Yang N, Song SL, Xu CH. Icariin Accelerates Fracture Healing via Activation of the WNT1/β-catenin Osteogenic Signaling Pathway. Curr Pharm Biotechnol 2020; 21:1645-1653. [PMID: 32525771 DOI: 10.2174/1389201021666200611121539] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/15/2020] [Accepted: 05/18/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Icariin has been shown to enhance bone formation. OBJECTIVE The present study aimed to investigate whether icariin also promotes bone fracture healing and its mechanisms. METHODS First, we isolated and cultured rat bone marrow stromal cells (rBMSCs) with icariincontaining serum at various concentrations (0%, 2.5%, 5% and 10%) and then measured alkaline phosphatase (ALP) activity and the expression of Core-binding factor, alpha 1 (Cbfα1), bone morphogenetic protein-2 (BMP-2) and bone morphogenetic protein-4 (BMP-4) in the rBMSCs. Second, we established a model of fracture healing in rats and performed gavage treatment for 20 days. Then, we detected bone biochemical markers (ELISA kits) in the serum, fracture healing (digital radiography, DR), and osteocalcin expression (immunohistochemistry). RESULTS Icariin treatment increased ALP activity and induced the expression of Cbfα1, BMP-2 and BMP-4 in rBMSCs in a dose-dependent manner. In addition, Icariin increased the serum levels of osteocalcin (OC), bone-specific alkaline phosphatase (BAP), N-terminal telopeptides of type I collagen (NTX-1), C-terminal telopeptide of type I collagen (CTX-1) and tartrate-resistant acid phosphatase 5b (TRACP-5b); promoted osteocalcin secretion at the fracture site; and accelerated fracture healing. CONCLUSION Icariin can promote the levels of bone-formation markers, accelerate fracture healing, and activate the WNT1/β-catenin osteogenic signaling pathway.
Collapse
Affiliation(s)
- Xiao-Yun Zhang
- Department of Orthopedics, Ruikang Hospital Affiliated with the Guangxi University of Chinese Medicine, Nanning, 530011, China
| | - Yue-Ping Chen
- Department of Orthopedics, Ruikang Hospital Affiliated with the Guangxi University of Chinese Medicine, Nanning, 530011, China
| | - Chi Zhang
- Department of Orthopedics, Ruikang Hospital Affiliated with the Guangxi University of Chinese Medicine, Nanning, 530011, China
| | - Xuan Zhang
- Department of Orthopedics, Ruikang Hospital Affiliated with the Guangxi University of Chinese Medicine, Nanning, 530011, China
| | - Tian Xia
- Department of Orthopedics, Ruikang Hospital Affiliated with the Guangxi University of Chinese Medicine, Nanning, 530011, China
| | - Jie Han
- Department of Orthopedics, Ruikang Hospital Affiliated with the Guangxi University of Chinese Medicine, Nanning, 530011, China
| | - Nan Yang
- Department of Orthopedics, Ruikang Hospital Affiliated with the Guangxi University of Chinese Medicine, Nanning, 530011, China
| | - Shi-Lei Song
- Department of Orthopedics, Ruikang Hospital Affiliated with the Guangxi University of Chinese Medicine, Nanning, 530011, China
| | - Can-Hong Xu
- Department of Orthopedics, Ruikang Hospital Affiliated with the Guangxi University of Chinese Medicine, Nanning, 530011, China
| |
Collapse
|
6
|
The effects of short-term use of granulocyte colony-stimulating factor on bone metabolism in child cancer patients. North Clin Istanb 2018; 5:277-281. [PMID: 30859156 PMCID: PMC6371986 DOI: 10.14744/nci.2017.59320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 12/08/2017] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE: The granulocyte colony-stimulating factor (G-CSF) is the most commonly used hematopoietic growth factor recombinant DNA technology. It affects bone metabolism by modulating both osteoclast and osteoblast functions. The aim of the present study was to investigate the effects of short-term use of G-CSF on bone metabolism in children with leukemia and solid tumors. METHODS: Thirty-six patients with a malignancy who received G-CSF therapy according to chemotherapy protocols and another 20 growth factor-free cancer patients who were enrolled as controls were included in the study. The serum osteocalcin and urinary free deoxypyridinoline levels were measured before the start of G-CSF therapy, on day 3 after treatment, and 7 days after G-CSF therapy was discontinued. In the control group, the measurements were made during corticosteroid and methotrexate-free chemotherapy. RESULTS: The mean osteocalcin level (8.6±2.3 ng/mL) from before the onset of treatment decreased significantly (7.7±2.3 ng/mL) on day 3 of G-CSF therapy and significantly increased after 7 days of G-CSF therapy (7.9±2.2 ng/mL) (p<0.001 and p<0.001, respectively), which was still significantly lower than the pre-G-CSF values (p<0.001). The urinary free deoxypyridinoline level significantly increased on day 3 of G-CSF treatment (25.6±6.5 nmol/mmol Cr) and significantly decreased after 7 days of G-CSF therapy (22.6±6.4 nmol/mmol Cr) (p<0.001 and p<0.001, respectively), which was still significantly higher than the values recorded before G-CSF therapy (p<0.001). CONCLUSION: The findings show that the short-term use of G-CSF in children with cancer can affect bone metabolism and can play a role in metabolic changes. Decreased osteoblastic activity and increased osteoclastic activity suggest that osteoporosis may be associated with bone pain in these patients.
Collapse
|
7
|
Moukoko D, Pourquier D, Genovesio C, Thezenas S, Chabrand P, Roffino S, Pithioux M. Granulocyte-colony stimulating factor enhances bone fracture healing. Clin Biomech (Bristol, Avon) 2018; 58:62-68. [PMID: 30036852 DOI: 10.1016/j.clinbiomech.2018.07.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 04/27/2018] [Accepted: 07/11/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Circulating mesenchymal stem cells contribute to bone repair. Their incorporation in fracture callus is correlated to their bioavailability. In addition, Granulocyte-colony stimulating factor induces the release of vascular and mesenchymal progenitors. We hypothesized that this glycoprotein stimulates fracture healing, and analyzed the effects of its administration at low doses on bone healing. METHODS 27 adult male Sprague-Dawley rats underwent mid-femur osteotomy stabilized by centromedullar pinning. In a post (pre) operative group, rats were subcutaneously injected with 5 μg/kg per day of Granulocyte-colony stimulating factor for 5 days after (before) surgery. In a control group, rats were injected with saline solution for 5 days immediately after surgery. A radiographic consolidation score was calculated. At day 35, femurs were studied histologically and underwent biomechanical tests. FINDINGS 5 weeks after surgery, mean radiographic scores were significantly higher in the Preop group 7.75 (SD 0.42) and in the Postop group 7.67 (SD 0.52) than in the control group 6.75 (SD 0.69). Biomechanical tests showed femur stiffness to be more than three times higher in both the Preop 109.24 N/mm (SD 51.86) and Postop groups 100.05 N/mm (SD 60.24) than in control 32.01 N/mm (SD 15.78). Mean maximal failure force was twice as high in the Preop group 68.66 N (SD 27.78) as in the control group 34.21 N (SD 11.79). Histological results indicated a later consolidation process in control than in treated groups. INTERPRETATION Granulocyte-colony stimulating factor injections strongly stimulated early femur fracture healing, indicating its potential utility in human clinical situations such as programmed osteotomy and fracture.
Collapse
Affiliation(s)
- Didier Moukoko
- Département de Chirurgie Orthopédique Pédiatrique, CHU Angers, 4 rue Larrey, 49100 Angers, France
| | - Didier Pourquier
- Institut régional du Cancer de Montpellier (ICM)- Val d'Aurelle, Montpellier, France
| | - Cécile Genovesio
- Laboratoire de Biochimie, Faculté de Pharmacie, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - Simon Thezenas
- Institut régional du Cancer de Montpellier (ICM)- Val d'Aurelle, Montpellier, France
| | - Patrick Chabrand
- Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, Marseille, France; APHM, Hôpital Sainte Marguerite, IML, Marseille, France
| | - Sandrine Roffino
- Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, Marseille, France; Université Côte d'Azur, Univ Nice Sophia Antipolis, France
| | - Martine Pithioux
- Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, Marseille, France; APHM, Hôpital Sainte Marguerite, IML, Marseille, France.
| |
Collapse
|
8
|
Moore DC, Pellegrino AE. Pegfilgrastim-Induced Bone Pain: A Review on Incidence, Risk Factors, and Evidence-Based Management. Ann Pharmacother 2017; 51:797-803. [DOI: 10.1177/1060028017706373] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: To review the incidence, risk factors, and management of pegfilgrastim-induced bone pain (PIBP). Data Sources: PubMed was searched from 1980 to March 31, 2017, using the terms pegfilgrastim and bone pain. Study Selection and Data Extraction: English-language, human studies and reviews assessing the incidence, risk factors, and management of PIBP were incorporated. Data Synthesis: A total of 3 randomized, prospective studies and 2 retrospective studies evaluated pharmacological management of PIBP. Naproxen compared with placebo demonstrated a reduction in the degree, incidence, and duration of bone pain secondary to pegfilgrastim. Loratadine was not effective in reducing the incidence of bone pain prophylactically, but a retrospective study evaluating dual antihistamine blockade with loratadine and famotidine demonstrated a decreased incidence in bone pain when administered before pegfilgrastim. Conclusion: Naproxen is effective at managing PIBP. Although commonly used, antihistamines have a paucity of data supporting their use. Dose reductions of pegfilgrastim and opioids may also be potential management options; however, data supporting these treatment modalities are scarce.
Collapse
Affiliation(s)
- Donald C. Moore
- Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC, USA
| | | |
Collapse
|
9
|
Changes in bone mass during the perimenopausal transition in naturally menopausal cynomolgus monkeys. Menopause 2016; 23:87-99. [DOI: 10.1097/gme.0000000000000556] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
10
|
Saba F, Soleimani M, Atashi A, Mortaz E, Shahjahani M, Roshandel E, Jaseb K, Saki N. The role of the nervous system in hematopoietic stem cell mobilization. ACTA ACUST UNITED AC 2014; 19:8-16. [PMID: 24165704 DOI: 10.1532/lh96.12013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Hematopoietic stem cells (HSCs) and blood cell progenitors, such as maturing leucocytes, steadily enter from bone marrow (BM) into the circulation under steady-state conditions, and their mobilization is dramatically amplified during stress conditions and by mediators such as granulocyte colony-stimulating factor (G-CSF). This mobilization is dependent upon bone remodeling, the proteolytic enzymes of bone marrow-derived stromal cells, and adhesion molecules such as integrin, but the main mechanisms controlling this traffic are still unclear. The nervous system, as the most important regulator of the body, can affect the mobilization network by secreting catecholamines, so that denervation of catecholaminergic fibers in the BM of mice could lead to declining mobilization in steady state and stress situations, even in the presence of other intact environmental factors in the BM. Thus, due to the importance of the nervous system, we have attempted to give a general overview of how the nervous system is involved in the mobilization of HSCs in this review. Then, we will try to describe the mobilization process induced by the nervous system, which consists of 3 mechanisms: stromal cell-derived factor 1 (SDF-1)/CXC chemokine receptor type 4 (CXCR4), proteolytic enzymes, and bone remodeling.
Collapse
Affiliation(s)
- Fakhredin Saba
- Department of Hematology, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | | | | | | | | | | | | | | |
Collapse
|
11
|
Karafin MS, Graminske S, Erickson P, Walters MC, Scott EP, Carter S, Padmanabhan A. Evaluation of the spectra optia apheresis system for mononuclear cell (MNC) collection in G-CSF mobilized and nonmobilized healthy donors: Results of a multicenter study. J Clin Apher 2014; 29:273-80. [DOI: 10.1002/jca.21319] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Accepted: 01/27/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Matthew S. Karafin
- Medical Sciences Institute, Blood Center of Wisconsin; Milwaukee Wisconsin
- Medical College of Wisconsin; Milwaukee Wisconsin
| | - Sharon Graminske
- Applied Research Laboratory, Blood Center of Wisconsin; Milwaukee Wisconsin
| | | | - Mark C. Walters
- LeukoLab; Alameda California
- Children's Hospital & Research Center; Oakland California
| | | | | | - Anand Padmanabhan
- Medical Sciences Institute, Blood Center of Wisconsin; Milwaukee Wisconsin
- Medical College of Wisconsin; Milwaukee Wisconsin
| |
Collapse
|
12
|
The five “Ws” for bone pain due to the administration of granulocyte-colony stimulating factors (G-CSFs). Crit Rev Oncol Hematol 2014; 89:112-28. [DOI: 10.1016/j.critrevonc.2013.08.006] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 07/26/2013] [Accepted: 08/13/2013] [Indexed: 11/21/2022] Open
|
13
|
Mueller MM, Bialleck H, Bomke B, Brauninger S, Varga C, Seidl C, Seifried E, Tonn T, Bonig H. Safety and efficacy of healthy volunteer stem cell mobilization with filgrastim G-CSF and mobilized stem cell apheresis: results of a prospective longitudinal 5-year follow-up study. Vox Sang 2012; 104:46-54. [PMID: 22827736 DOI: 10.1111/j.1423-0410.2012.01632.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVES G-CSF-mobilized peripheral blood stem cells have long replaced marrow as the major source for allogeneic transplants. Conclusive evidence questioning the long-term safety of G-CSF for donors has not been provided, but the cumulative number of followed donors remains insufficient to rule out rare adverse events. A long-term active follow-up study of G-CSF-mobilized healthy volunteer donors was therefore performed. PATIENTS AND METHODS Two hundred and three successive donors were evaluated pre-apheresis, subjected to G-CSF-mobilization/apheresis, and actively followed for 5 years by the same physicians and laboratories. Follow-up laboratory work included standard biochemical/haematological tests and T-cell phenotyping. RESULTS Donor epidemiology was typical for reported stem cell donor cohorts. Acute adverse effects of G-CSF and apheresis were mild and transient, consistent with the previous reports. Mean circulating CD34(+) cells after nine doses of G-CSF were 124 per μl. Other biochemical/haematological parameters were also altered, consistent with G-CSF treatment. Spleen enlargement was modest. At first follow-up, all clinical and laboratory parameters had normalized. Leucocyte/lymphocyte counts and CD4/CD8 ratios were the same as during premobilization work-up and remained unchanged throughout. A single severe but likely unrelated adverse event, a case of papillary thyroid carcinoma, was reported. CONCLUSION The studies add an observation time of almost 500 donor years to the growing body of evidence of the long-term safety of G-CSF for allogeneic donor stem cell mobilization.
Collapse
Affiliation(s)
- M M Mueller
- German Red Cross Blood Transfusion Service and Institute for Transfusion Medicine and Immunohematology of the Goethe University, Frankfurt, Germany
| | | | | | | | | | | | | | | | | |
Collapse
|
14
|
|
15
|
Abstract
Under normal conditions, the great majority of hematopoietic stem/progenitors cells (HSPCs) reside in the bone marrow. The number of HSPCs in the circulation can be markedly increased in response to a number of stimuli, including hematopoietic growth factors, myeloablative agents and environmental stresses such as infection. The ability to 'mobilize' HSPCs from the bone marrow to the blood has been exploited clinically to obtain HSPCs for stem cell transplantation and, more recently, to stimulate therapeutic angiogenesis at sites of tissue ischemia. Moreover, there is recent interest in the use of mobilizing agents to sensitize leukemia and other hematopoietic malignancies to cytotoxic agents. Key to optimizing clinical mobilizing regimens is an understanding of the fundamental mechanisms of HSPC mobilization. In this review, we discuss recent advances in our understanding of the mechanisms by which granulocyte colony-stimulating factor (G-CSF), the prototypical mobilizing agent, induces HSPC mobilization.
Collapse
|
16
|
Hematopoietic colony-stimulating factors: new players in tumor-nerve interactions. J Mol Med (Berl) 2010; 89:321-9. [PMID: 21079906 PMCID: PMC3055988 DOI: 10.1007/s00109-010-0697-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2010] [Revised: 10/02/2010] [Accepted: 10/28/2010] [Indexed: 12/30/2022]
Abstract
A variety of cancers are accompanied by debilitating pain, which constitutes the primary reason for poor quality of life in cancer patients. There is an urgent demand for the development of specific mechanism-based therapies against cancer pain. Recently, important advances have been made in mechanisms contributing to cancer pain. A notable finding was that the tumor-derived hematopoietic growth factors, granulocyte- and granulocyte-macrophage-colony-stimulating factors (G-CSF/GM-CSF), subserve important functions in the generation of pain hypersensitivity in tumor-affected regions. In this context, their receptors were unexpectedly found on pain-sensing nerves and were observed to be functionally linked to nociceptive sensitization and tumor-induced pain. Here, we review evidence supporting a role for G-/GM-CSF in sensitization of pain-sensing nerves, the underlying signaling pathways and the cross-talk with other pronociceptive cytokines, peptides and modulators derived from immune cells, osteoclasts and tumor cells. These findings hold implications in the therapy of pain in disease states, such as cancer and rheumatoid arthritis.
Collapse
|
17
|
Wu YD, Chien CH, Chao YJ, Hamrick MW, Hill WD, Yu JC, Li X. Granulocyte colony-stimulating factor administration alters femoral biomechanical properties in C57BL/6 mice. J Biomed Mater Res A 2008; 87:972-9. [DOI: 10.1002/jbm.a.31840] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
|
18
|
Biologic and molecular effects of granulocyte colony-stimulating factor in healthy individuals: recent findings and current challenges. Blood 2007; 111:1767-72. [PMID: 18057230 DOI: 10.1182/blood-2007-07-097543] [Citation(s) in RCA: 106] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Recombinant human granulocyte colony-stimulating factor (rhG-CSF) is widely used in healthy donors for collection of peripheral blood progenitor cells (PBPCs) for allogeneic transplantation and granulocytes for transfusion. The spectrum of its biologic and molecular activities in healthy individuals is coming into sharper focus, creating a unique set of challenges and clarifying the need to monitor and safeguard donor safety. Accumulating evidence indicates that rhG-CSF effects are not limited to the myeloid cell lineage. This may reflect the presence of functional G-CSF receptors on other cell types and tissues, as well as rhG-CSF-induced modulation of cytokine networks. While most rhG-CSF-induced effects are transient and self-limiting, preliminary, provocative data have suggested the possibility of a more durable effect on the chromosomal integrity of lymphocytes. While these reports have not been validated and have been subject to criticism, they are prompting prospective studies and monitoring efforts to determine whether there is a significant risk of long-term adverse events (eg, hematologic malignancies) in healthy PBPC and granulocyte donors. Based on the totality of information that is currently available, the administration of rhG-CSF to healthy donors for the purpose of PBPC donation continues to have a favorable risk-benefit profile.
Collapse
|
19
|
Katayama Y, Battista M, Kao WM, Hidalgo A, Peired AJ, Thomas SA, Frenette PS. Signals from the sympathetic nervous system regulate hematopoietic stem cell egress from bone marrow. Cell 2006; 124:407-21. [PMID: 16439213 DOI: 10.1016/j.cell.2005.10.041] [Citation(s) in RCA: 979] [Impact Index Per Article: 54.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2005] [Revised: 09/19/2005] [Accepted: 10/27/2005] [Indexed: 12/29/2022]
Abstract
Hematopoietic stem and progenitor cells (HSPC), attracted by the chemokine CXCL12, reside in specific niches in the bone marrow (BM). HSPC migration out of the BM is a critical process that underlies modern clinical stem cell transplantation. Here we demonstrate that enforced HSPC egress from BM niches depends critically on the nervous system. UDP-galactose ceramide galactosyltransferase-deficient (Cgt(-/-)) mice exhibit aberrant nerve conduction and display virtually no HSPC egress from BM following granulocyte colony-stimulating factor (G-CSF) or fucoidan administration. Adrenergic tone, osteoblast function, and bone CXCL12 are dysregulated in Cgt(-/-) mice. Pharmacological or genetic ablation of adrenergic neurotransmission indicates that norepinephrine (NE) signaling controls G-CSF-induced osteoblast suppression, bone CXCL12 downregulation, and HSPC mobilization. Further, administration of a beta(2) adrenergic agonist enhances mobilization in both control and NE-deficient mice. Thus, these results indicate that the sympathetic nervous system regulates the attraction of stem cells to their niche.
Collapse
Affiliation(s)
- Yoshio Katayama
- Department of Medicine, Immunobiology Center and Black Family Stem Cell Institute, Mount Sinai School of Medicine, New York, NY 10029, USA
| | | | | | | | | | | | | |
Collapse
|
20
|
Haddad S, Leitman SF, Wesley RA, Cecco S, Yau YY, Starling J, Rehak NN, Bolan CD. Placebo-controlled study of intravenous magnesium supplementation during large-volume leukapheresis in healthy allogeneic donors. Transfusion 2005; 45:934-44. [PMID: 15934992 DOI: 10.1111/j.1537-2995.2005.04312.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Marked decreases in ionized magnesium (iMg) levels occur during large-volume leukapheresis (LVL); however, the effect of intravenous (IV) magnesium supplementation in this setting has not been carefully studied. STUDY DESIGN AND METHODS Thirty healthy allogeneic peripheral blood progenitor cell donors receiving citrate anticoagulant with IV calcium prophylaxis were randomized to receive either IV magnesium (0.2 mg Mg per mL acid citrate dextrose-A) or placebo during LVL, with a double-blind design. RESULTS Thirty subjects underwent 75 LVL pro- cedures, 37 with magnesium and 38 with placebo. Group characteristics were similar for sex, weight, citrate infusion rate (1.36 mg/kg/min vs. 1.37 mg/kg/min), and volume processed (16 L vs. 17 L). Serum iMg levels remained within the reference range with magnesium supplementation, but decreased 39+/-11 percent below baseline (p<10(-10)) after placebo, with greater decreases after consecutive procedures. Subjects receiving magnesium had more vigorous parathyroid hormone responses and higher glucose levels and also tended to have higher serum potassium and ionized calcium levels. Mild paresthesias, coldness, and nausea occurred in 28, 20, and 7 percent of donors, respectively, with no significant differences between groups. Severe symptoms (chest tightness) occurred in only one subject receiving placebo. CONCLUSION IV magnesium supplementation exerts a significant impact on serum magnesium levels, but does not reduce the frequency or severity of the relatively mild citrate-related effects observed in LVL performed with continuous IV calcium prophylaxis.
Collapse
Affiliation(s)
- Salim Haddad
- Department of Transfusion Medicine, Warren Grant Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland, USA.
| | | | | | | | | | | | | | | |
Collapse
|
21
|
Abstract
Abstract
Donation of hematopoietic stem cells, either through bone marrow or peripheral blood collection, is a generally safe procedure for healthy donors. Serious adverse events are uncommon and death is exceedingly rare. Nevertheless, all donors must be carefully evaluated and fully informed prior to donation. This should be done by clinicians having good understanding of the potential physical and psychological complications of donation and the factors that may increase these risks. Additionally, donors and graft products must be evaluated for the potential to transmit infections and other diseases to the recipient and to satisfy an increasing number of national and international regulatory requirements. Donors must be able to provide informed consent without coercion or pressure. Special attention to the clinical, psychological and social needs of pediatric donors is necessary.
Collapse
Affiliation(s)
- Mary M Horowitz
- Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
| | | |
Collapse
|
22
|
Affiliation(s)
- Bela Balint
- Military Medical Academy, Institute of Transfusiology, Belgrade, Serbia & Montenegro
| |
Collapse
|
23
|
Affiliation(s)
- G A Haegerstam
- Medical Department, Astra Läkemedel AB, Södertälje, Sweden.
| |
Collapse
|
24
|
Fischmeister G, Gadner H. Granulocyte colony-stimulating factor versus granulocyte-macrophage colony-stimulating factor for collection of peripheral blood progenitor cells from healthy donors. Curr Opin Hematol 2000; 7:150-5. [PMID: 10786651 DOI: 10.1097/00062752-200005000-00004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The harvesting of peripheral blood progenitor cells (PBPCs) after granulocyte colony-stimulating factor or granulocyte-macrophage colony-stimulating factor stimulation instead of bone marrow in healthy donors has become increasingly popular. Donors, given the choice between bone marrow and PBPC donation, often prefer cytapheresis because of the easier access, no necessity for general anesthesia, and no multiple bone marrow punctures. In addition, accelerated engraftment and immunomodulation by granulocyte colony-stimulating factor-mobilized PBPCs are advantageous for the recipient. However, because of donor inconvenience and poor mobilization, there is a need to develop improved procedures. Aspects such as durability of hematopoietic engraftment, characterization of the earliest stem cell, and composition of PBPCs are not yet well defined, and international donor registration and follow-up must be considered when evaluating long-term safety profiles in healthy donors. This review concentrates on the most significant developments on mobilization of PBPCs published during the past year.
Collapse
Affiliation(s)
- G Fischmeister
- St. Anna Children's Hospital and Children's Cancer Research Institute, Vienna, Austria
| | | |
Collapse
|
25
|
Abstract
Recently, several groups have begun to administer granulocyte colony-stimulating factor (G-CSF), a hematopoietic growth factor, with or without dexamethasone to mobilize peripheral blood neutrophils. Granulocyte colony-stimulating factor (600 microg subcutaneously) and dexamethasone (8 mg orally) given 12 hours before standard leukapheresis routinely results in the collection of approximately 80 x 10(9) granulocytes. This number of cells is sufficient to increase the neutrophil count of a severely neutropenic patient to normal and restore the recipients' ability to develop a neutrophil response in tissues. Several trials are ongoing to establish the clinical benefit of this new approach to supportive care for neutropenic patients.
Collapse
Affiliation(s)
- D C Dale
- Department of Medicine, University of Washington, Seattle 98195-6422, USA
| | | |
Collapse
|