A Comparison of Efficacy of Sargramostim (Yeast-Derived RhuGM-CSF) and Filgrastim (Bacteria-Derived RhuG-CSF) in the Therapeutic Setting of Chemotherapy-Induced Myelosuppression

Abstract

A randomized, double-blind, multicenter study in 181 afebrile cancer patients with ANC levels < 500/microL receiving myelosuppressive chemotherapy was undertaken to compare sargramostim (yeast-derived recombinant human granulocyte-macrophage colony-stimulating factor, RhuGM-CSF) and filgrastim (bacteria-derived recombinant human granulocyte colony-stimulating factor, RhuG-CSF) in the treatment of chemotherapy-induced myelosuppression. Patients received daily subcutaneous (SC) injections of either agent until ANC levels reached at least 1500/microL. There was no statistical difference between treatment groups in the mean number of days to reach an ANC of 500/microL, but the mean number of days to reach ANC levels of 1000/microL and 1500/microL was approximately one day less in patients receiving filgrastim. Fewer patients in the sargramostim arm were hospitalized, and they had a shorter mean length of hospitalization, mean duration of fever, and mean duration of i.v. antibiotic therapy compared with patients who received filgrastim. Both growth factors were well tolerated. No patient was readmitted to the hospital after growth factor was discontinued. Sargramostim and filgrastim have comparable efficacy and tolerability in the treatment of standard-dose chemotherapy-induced myelosuppression in community practice.

Inflammation-Related Cytokines of Aqueous Humor in Acute Primary Angle-Closure Eyes

“…As would be expected, the current APAC group had the highest IOP (48.5 mm Hg), followed by the previous APAC group (26.0 mm Hg), and the cataract group (13.3 mm Hg) (all P < 0.0167). The median duration before surgery of the current APAC group was 3.0 days (range, 1-7 days), and that of the previous APAC group was 20.0 days (range, 11-30 days; P < 0.001).…”

“…Inflammatory chemokines are produced in high concentrations during infection or injury and determine the migration of inflammatory leukocytes into the damaged area. G-CSF is used to stimulate the survival, proliferation, differentiation, and function of granulocytes, 20 which play an important role in inflammation. Previous studies of inflammatory eye disease 3,21,22 have reported that increased IL-6, IL-8, and MCP-1 levels, in addition to the shifting of the granulocyte stimulating factor from primary GM-CSF to G-CSF, were commonly associated with intraocular inflammation, regardless of disease etiology.…”

Utilization of G-CSF and GM-CSF as an alternative to discontinuation in clozapine-induced neutropenia or leukopenia: A case report and discussion

“…Injection site reactions as well as exacerbation of preexisting inflammatory conditions have similar frequencies between the two. Comparative safety and efficacy data of G-CSF versus GM-CSF are limited and conflicting, and the long-term consequences of maintenance G-CSF or GM-CSF use in the absence of a primary hematological problem are unclear 30-33. For this reason, choice of one agent over the other is generally based on the system's formulary preference.…”

Immunomodulatory Response Triggered by the Alkaloids, 3-Amino- 7-Benzylbenzimidazo[3,2-a] Quinolinium Chloride (ABQ-48) and 3-Nitro- 7-Benzylbenzimidazo[3,2-a] Quinolinium Chloride (NBQ-48)

“…For many patients, not only the cancer, but also the therapy itself undermines their daily activities. In this regard, several anticancer chemotherapies are combined with G-CSF (Filgrastim, commercially traded as Neupogen*, or Pegfilgrastim commercially traded as Neulasta*) to stimulate proliferation and differentiation of granulocytes [20]. This combination is effectively used to enhance the quality of life of patients suffering from cancer [21,22] by restoring the levels of neutrophils in blood [23-25].…”

“…This study shows ABQ-48 and NBQ-48 to effectively induce both effects: control of tumor growth and immune modulation to produce G-CSF, among other cytokines. Therefore, ABQ-48 and NBQ-48 could induce tumor-proliferation control with minimal side effects after stimulating proliferation and differentiation of granulocytes [20] and at some degree restoring the levels of neutrophils in blood.…”