Neutropenia chemotherapy-related

Muderspach et al. (31) reported the results of a pilot study of concurrent carboplatin (30 mg/m2 twice weekly) with radiation in 22 patients with stage IIA (>4 cm) to IIIB disease. The most significant chemotherapy-related side effects were grade 3 neutropenia and anemia. The authors reported 19 complete responders to this regimen, although only 11 patients were alive and disease-free at the time of their report. Because cisplatin... 

G. Other applications Leukine has been effective in producing increases in normally functioning neutrophils, eosinophils, and monocytes in AIDS patients and patients with leukopenia. Leukine may prolong survival when used as adjuvant therapy in patients with stage III or IV malignant melanoma. Leukine has also been effective in abrogating chemotherapy-related neutropenia in cancer patients, with a reduction in the severity and duration of chemotherapy-induced myelosuppression. 

F. Role in therapy According to Micro-medex, treatment of severe chemotherapy-related thrombocytopenia is hmited to platelet transfusions. There is a need for an alternative, especially due to the frequent use of myeloid colony-stimulating factors (G-CSF, GM-CSF) to reduce febrile neutropenia although effective, their use increases the risk of acute and prolonged thrombocytopenia, and the need for platelet transfusions. Other cytokines, such as interleukin-1 and interleukin-6, have been investigated as a means of ameliorating chemotherapy-induced thrombocytopenia, but results have been equivocal. 

Catheter-related bacteremia due to Pseudomonas paucimobilis has been reported in two patients with cancer-associated neutropenia (25). This organism has rarely been implicated in community-acquired and nosocomial infections. Both patients had been undergoing intensive chemotherapy, and both required removal of the catheter to eradicate the infection. 

Children In a retrospective study, children with neutropenia were given prophylactic intravenous micafungin 3 mg/kg/day in 131 cycles after chemotherapy (39 patients) and 15 cycles after hemopoietic stem cell transplantation (14 patients) [100. There were no adverse events that could be related to micafungin. 

A-II, were identified. Protein expression profiles determined by MS are thus useful for idenfilying treatment-responsive proteins [25], Toxicity can be severe in case of chemotherapy. MS-based techniques may also be applied to reduce side effects. A study evaluated the association between exposure to unbound docetaxel and neutropenia in cancer patients and identified factors influencing unbound docetaxel clearance. Pharmacokinetic studies and toxicity assessments were performed during the first cycle of therapy. Total docetaxel concentrations were determined by HPLC-MS-MS. The authors conclude that as exposure to unbound docetaxel is closely related to drug-induced hematologic toxicity, this needs to be considered in future pharmacological investigations [26]. 

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