Single Dose Filgastrim in Cytotoxic-Induced Neutropaenia in Children

East Afr Med J. 2008 Jan;85(1):30-5. doi: 10.4314/eamj.v85i1.9603.

Abstract

Objective: To document the impact of fixed dose weight adjusted filgastrim (G-CSF) in cytotoxic-induced neutropaenia.

Design: A descriptive cross-sectional study.

Setting: Paediatric Oncology Unit at Kenyatta National Hospital, Nairobi, Kenya.

Subjects: All paediatric oncology patients who had developed cytotoxic-induced neutropaenia.

Main outcome measures: The following were documented for every tissue proven case of malignancy; age, sex, type of malignancy, treatment regimen and schedule, initial blood count at the time of neutropaenia; subsequent blood counts daily for five days from day one of single dose filgastrim, and the calculated neutrophil incremental count.

Results: Initially eight patients with solid tumours previously treated with filgastrim revealed that cytotoxic induced neutropaenia could be ameliorated by a single dose of filgastrim. Subsequently, the study listed thirty patients. This cohort consisted of; 37% rhabdomyosarcoma, 30% Burkitts, 27% acute lymphoblastic leukaemia and 6% Hodgkin's lymphoma. Increased neutrophil count after 48 hours was documented in 26 (87%) patients, with absolute neutrophil counts range of 0.5 to 31.5 x 10(9)/L. This response was significantly influenced by gender (p>0.0001), malignancy type and chemotherapy regimen (p>0.001).

Conclusion: The study shows that chemotherapy induced neutropaenia can be alleviated by a single dose of filgastrim without adverse effects on lymphoblastic leukaemia. This study suggests that a single dose of filgastrim should be first tried in cytotoxic induced neutropaenia in the paediatric age group.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Cytotoxins / adverse effects*
  • Female
  • Filgrastim
  • Granulocyte Colony-Stimulating Factor / administration & dosage
  • Granulocyte Colony-Stimulating Factor / therapeutic use*
  • Health Status Indicators
  • Humans
  • Kenya / epidemiology
  • Male
  • Neutropenia / chemically induced
  • Neutropenia / drug therapy*
  • Neutropenia / epidemiology
  • Recombinant Proteins
  • Retrospective Studies

Substances

  • Cytotoxins
  • Recombinant Proteins
  • Granulocyte Colony-Stimulating Factor
  • Filgrastim