DISPOSITION OF RECOMBINANT HUMAN GRANULOCYTE-COLONY-STIMULATING FACTOR IN CHILDREN WITH SEVERE CHRONIC NEUTROPENIA

被引:54
作者
KEARNS, CM
WANG, WC
STUTE, N
IHLE, JN
EVANS, WE
机构
[1] ST JUDE CHILDRENS RES HOSP, DEPT PHARMACEUT SCI, 332 N LAUDERDALE, MEMPHIS, TN 38101 USA
[2] ST JUDE CHILDRENS RES HOSP, DEPT HEMATOL ONCOL, MEMPHIS, TN 38101 USA
[3] ST JUDE CHILDRENS RES HOSP, DEPT BIOCHEM, MEMPHIS, TN 38101 USA
[4] UNIV TENNESSEE CTR HLTH SCI, CTR PEDIAT PHARMACOKINET & THERAPEUT, MEMPHIS, TN 38163 USA
[5] UNIV TENNESSEE CTR HLTH SCI, DEPT PEDIAT, MEMPHIS, TN 38163 USA
[6] UNIV TENNESSEE CTR HLTH SCI, DEPT CLIN PHARM, MEMPHIS, TN 38163 USA
关键词
D O I
10.1016/S0022-3476(05)81760-3
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
The disposition of recombinant human granulocyte colony-stimulating factor (G-CSF) was studied in 11 children with severe chronic neutropenia given 6 to 48 mug G-CSF per kilogram subcutaneously. Serum concentrations of G-CSF were measured by bioassay. Peak serum G-CSF concentrations were proportional to dosage and occurred 2 to 8 hours after subcutaneous administration. Nine of the eleven children had a significant increase in absolute neutrophil count (ANC). The median ANC in responding patients was 6.7 X 10(9)/L on day 14 versus 0.17 X 10(9)/L on day 1 of therapy (p < 0.01). The G-CSF clearance increased as ANC increased, and the relationship was well described by a sigmoid model. Maximal clearance approached 2 ml/min per kilogram at ANCs > 17.0 X 10(9)/L; minimal clearance was 0.29 ml/min per kilogram at ANCs of 0. The half-life of G-CSF was inversely related to ANC; mean half-life was 4.7 hours at ANCs of 0 but < 2 hours of ANCs greater than 17.0 X 10(9)/L. The two patients who failed to achieve a clinical response had no change in G-CSF clearance or half-life, nor did they have an increase in ANC when G-CSF dosages were escalated to 18 or 48 mug/kg twice a day. These results indicate that G-CSF pharmacokinetics are directly influenced by ANC; higher serum concentrations, slower clearances, and longer half-lives are associated with low ANCs.
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页码:471 / 479
页数:9
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