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Forneris NW, Chedid S. Individualized Treatment Approach for Rectal Adenocarcinoma in the Setting of Congenital Neutropenia. Cureus 2024; 16:e56383. [PMID: 38633978 PMCID: PMC11022976 DOI: 10.7759/cureus.56383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 03/18/2024] [Indexed: 04/19/2024] Open
Abstract
Congenial neutropenia is a rare genetic disorder that puts individuals at risk of life-threatening bacterial infections early in life, and the current standard of care includes the use of colony-stimulating factors or curative intent bone marrow transplant. Cancer treatment strategies that include surgery, chemotherapy, radiation, and immunotherapy present significant challenges to an individual with a baseline immunodeficiency as seen in this condition. Evidence-based national guidelines aid physicians and patients in moving through complex cancer care regimens. However, these are altered when the intensity of the patient's comorbidities puts them at increased risk of developing a potentially life-threatening infection. Here, we present a patient treated for rectal carcinoma in the setting of severe congenital neutropenia.
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Affiliation(s)
- Nicole W Forneris
- Medicine, William Carey University College of Osteopathic Medicine, Hattiesburg, USA
| | - Solly Chedid
- Oncology, Singing River Hospital System, Gulfport, USA
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Islami MM, Khan MA, Aseeri MA, Alshamrani MA, Alnatsheh A, Alamoudi S, Alzahrani AA. Comparison of Biosimilar Filgrastim with Innovator Fligrastim for Peripheral Blood Stem Cells Mobilization, Collection of CD34+ Stem Cells, and Engraftment in Patients Undergoing Autologous and Allogeneic Stem Cell Transplantation: A Single-Center Experience. Ann Transplant 2023; 28:e938585. [PMID: 36864713 PMCID: PMC9990321 DOI: 10.12659/aot.938585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND In the Middle East, there is lack of data on peripheral blood CD34+stem cells mobilization by using biosimilar filgrastim. We have been using both Neupogen and a biosimilar G-CSF) Zarzio® (as a mobilizing agent since February 2014 for both allogenic and autologous stem cell transplantations. MATERIAL AND METHODS This was a single-center retrospective study. All patients and healthy donors who received either the biosimilar G-CSF (Zarzio®) or original G-CSF (Neupogen®) for mobilization of CD34+ stem cells were included in the study. The primary goal was to determine and compare the rate of successful harvest and amount of CD34+ stem cells collected in either adult cancer patients or healthy donors between Zarzio® and Neupogen® groups. RESULTS A total of 114 patients, including 97 cancer patients and 17 healthy donors, underwent successful CD34+ stem cell mobilization using G-CSF with chemotherapy (35 with Zarzio® +chemotherapy, 39 with Neupogen® +chemotherapy) or G-CSF as monotherapy (14 with Zarzio®, 9 with Neupogen®) in autologous transplantation. In an allogeneic stem cell transplantation, successful harvest was achieved by using G-CSF monotherapy (8 with Zarzio®, 9 with Neupogen®). There was no difference between Zarzio® and Neupogen® in the amount of CD34+ stem cells collected at leukapheresis. There was no difference with regards to secondary outcomes between the 2 groups. CONCLUSIONS Our study showed that biosimilar G-CSF (Zarzio®) has comparable efficacy to the original G-CSF (Neupogen®) when used for mobilization in both autologous and allogenic stem cell transplantation and was associated with significant cost saving.
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Affiliation(s)
- Maha M Islami
- Department of Pharmacy Practice, College of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mansoor Ahmed Khan
- Department of Pharmaceutical Care Services, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Mohammed A Aseeri
- Department of Pharmaceutical Care Services, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Majed A Alshamrani
- Department of Pharmaceutical Care Services, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Abdelmajid Alnatsheh
- Department of Pharmaceutical Care Services, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Sameer Alamoudi
- King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,Department of Adult Hematology and Bone Marrow Transplant, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia
| | - Ahmed A Alzahrani
- Department of General Surgery, King Fahd General Hospital, Jeddah, Saudi Arabia
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Gotera N, Hasan S, Shrestha P, Heleno C, Tesar A. A Case of Concurrent Leukocytosis and Systemic Capillary Leak Syndrome Due to Pegfilgrastim. Cureus 2022; 14:e24640. [PMID: 35663724 PMCID: PMC9156363 DOI: 10.7759/cureus.24640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2022] [Indexed: 11/05/2022] Open
Abstract
Pegfilgrastim is a granulocyte colony-stimulating factor agent used in patients receiving myelosuppressive therapy with chemotherapy or radiation. Two adverse effects associated with this agent include capillary leak syndrome and leukocytosis. To our knowledge, this is the first case of a patient who developed both systemic capillary leak syndrome and leukocytosis greater than 100,000 cells/µL after receiving pegfilgrastim. This patient received early fluid resuscitation, vasopressor support, and methylprednisolone, which improved her clinical course during hospitalization.
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Affiliation(s)
- Nico Gotera
- Internal Medicine, MercyOne North Iowa Medical Center, Mason City, USA
| | - Shayee Hasan
- Internal Medicine, MercyOne North Iowa Medical Center, Mason City, USA
| | - Pritee Shrestha
- Internal Medicine, MercyOne North Iowa Medical Center, Mason City, USA
| | - Caio Heleno
- Internal Medicine, MercyOne North Iowa Medical Center, Mason City, USA
| | - Amy Tesar
- Internal Medicine, MercyOne North Iowa Medical Center, Mason City, USA
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Rastogi S, Kalaiselvan V, Bin Jardan YA, Zameer S, Sarwat M. Comparative Study of Adverse Drug Reactions Associated with Filgrastim and Pegfilgrastim Using the EudraVigilance Database. Biology (Basel) 2022; 11:biology11020340. [PMID: 35205206 PMCID: PMC8869538 DOI: 10.3390/biology11020340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/09/2022] [Accepted: 02/16/2022] [Indexed: 11/16/2022]
Abstract
Simple Summary The most commonly reported adverse drug reactions (ADRs) related to filgrastim (FIL) and pegfilgrastim (PEG-F) were obtained and analyzed from the European EudraVigilance (EV) database. Frequently reported ADRs for FIL and PEG-F are pyrexia, bone pain, back pain, neutropenia and febrile neutropenia. No statistical difference in the probability of bone pain between FIL and PEG-F was observed. To further depict the safety of FIL and PEG-F, there is a further need to examine the real-life data. Abstract The primary prophylaxis with filgrastim (FIL) and pegfilgrastim (PEG-F) is recommended to decrease the severity of chemotherapy-induced neutropenia (CIN). The commonly reported adverse drug reactions (ADRs) with FIL and PEG-F is bone pain. ADRs pertaining to FIL and PEG-F were extracted from the European EudraVigilance (EV) database. The Individual Case Safety Reports (ICSRs) obtained from EV database that reported FIL and PEG-F as the suspected drug were analyzed. Registered ADRs (from the groups “General disorders and administration site conditions”, “Blood and lymphatic system disorders”, “Musculoskeletal and connective tissue disorders” and “Investigations”) for FIL and PEG-F were collected from EV database from 2007 to 5 June 2021. The reporting odds ratio (ROR) was used to calculate ICSRs with most common ADRs related to FIL and PEG-F. A total of 17,403 ICSRs described the incidence of most common ADRs of FIL and PEG-F. The commonly reported ADRs for both drugs were pyrexia, bone pain, back pain, neutropenia and febrile neutropenia. The odds ratio of ICSRs belonging to the System Organ Class (SOC) “Investigations” (ROR 1.01 (CI 0.93–1.10)) revealed no significant difference in FIL and PEG-F. However, for the SOCs (General disorders and administration site conditions” and “Musculoskeletal and connective tissue disorders” ((ROR 1.14 (CI 1.06–1.21); ROR 1.21 (CI 1.18–1.32), respectively), an increased reporting probability with PEG-F was found. The authors reported a lower reporting probability for the SOC “Blood and lymphatic system disorders” for FIL versus PEG-F (ROR 0.75 (CI 0.70–0.80)). Our results have demonstrated that the occurrence of bone pain was similar with FIL and PEG-F. For the incidence of pyrexia and back pain, PEG-F was associated with a higher reporting probability as compared to FIL. However, the incidence of neutropenia and febrile neutropenia was higher in FIL compared to PEG-F. Further evaluation of data from real life is needed.
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Affiliation(s)
- Shruti Rastogi
- Amity Institute of Pharmacy, Amity University, Noida 201313, India;
- Indian Pharmacopoeia Commission, Ministry of Health & Family Welfare, Government of India, Ghaziabad 201002, India;
| | - Vivekanandan Kalaiselvan
- Indian Pharmacopoeia Commission, Ministry of Health & Family Welfare, Government of India, Ghaziabad 201002, India;
| | - Yousef A. Bin Jardan
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Saima Zameer
- Department of Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI 49503, USA;
| | - Maryam Sarwat
- Amity Institute of Pharmacy, Amity University, Noida 201313, India;
- Correspondence: or
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Rubinstein MP, Salem ML, Doedens AL, Moore CJ, Chiuzan C, Rivell GL, Cole DJ, Goldrath AW. G-CSF/anti-G-CSF antibody complexes drive the potent recovery and expansion of CD11b+Gr-1+ myeloid cells without compromising CD8+ T cell immune responses. J Hematol Oncol 2013; 6:75. [PMID: 24279871 PMCID: PMC3850648 DOI: 10.1186/1756-8722-6-75] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 09/02/2013] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Administration of recombinant G-CSF following cytoreductive therapy enhances the recovery of myeloid cells, minimizing the risk of opportunistic infection. Free G-CSF, however, is expensive, exhibits a short half-life, and has poor biological activity in vivo. METHODS We evaluated whether the biological activity of G-CSF could be improved by pre-association with anti-G-CSF mAb prior to injection into mice. RESULTS We find that the efficacy of G-CSF therapy can be enhanced more than 100-fold by pre-association of G-CSF with an anti-G-CSF monoclonal antibody (mAb). Compared with G-CSF alone, administration of G-CSF/anti-G-CSF mAb complexes induced the potent expansion of CD11b+Gr-1+ myeloid cells in mice with or without concomitant cytoreductive treatment including radiation or chemotherapy. Despite driving the dramatic expansion of myeloid cells, in vivo antigen-specific CD8+ T cell immune responses were not compromised. Furthermore, injection of G-CSF/anti-G-CSF mAb complexes heightened protective immunity to bacterial infection. As a measure of clinical value, we also found that antibody complexes improved G-CSF biological activity much more significantly than pegylation. CONCLUSIONS Our findings provide the first evidence that antibody cytokine complexes can effectively expand myeloid cells, and furthermore, that G-CSF/anti-G-CSF mAb complexes may provide an improved method for the administration of recombinant G-CSF.
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Affiliation(s)
- Mark P Rubinstein
- Department of Biological Sciences, The University of California, San Diego, La Jolla, CA 92093, USA
- Department of Surgery, Medical University of South Carolina, Charleston, SC 29403, USA
- Department of Microbiology & Immunology, Medical University of South Carolina, Charleston, 86 Jonathan Lucas Street, HO506, SC 29403, USA
| | - Mohamed L Salem
- Department of Surgery, Medical University of South Carolina, Charleston, SC 29403, USA
- Zoology Department, Faculty of Science, Tanta University, Tanta, Egypt
| | - Andrew L Doedens
- Department of Biological Sciences, The University of California, San Diego, La Jolla, CA 92093, USA
| | - Caitlin J Moore
- Department of Surgery, Medical University of South Carolina, Charleston, SC 29403, USA
| | - Cody Chiuzan
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Guillermo L Rivell
- Department of Surgery, Medical University of South Carolina, Charleston, SC 29403, USA
| | - David J Cole
- Department of Surgery, Medical University of South Carolina, Charleston, SC 29403, USA
| | - Ananda W Goldrath
- Department of Biological Sciences, The University of California, San Diego, La Jolla, CA 92093, USA
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