泌尿器科癌患者における癌化学療法後の白血球減少症にたいするMuroctasin; MDP-Lys (L 18) (DJ-7041)の白血球回復効果について

Abstract

泌尿器科癌患者で癌化学療法施行による白血球減少に対するムロクタシンの白血球回復効果を検討した.1)登録症例は32例であり安全性解析の対象25例, 有用性解析対象24例, 有効解析対象23例であった.2)白血球数回復促進効果と概括安全度判定に基づいた有用率(有用以上)は100 μg投与群では61.5%, 50 μg投与群では45.5%であった.3)固形がん化学療法効果増強の判定基準による副作用記載様式による白血球減少のグレードは投与7日目で100 μg投与群は13例中6例, 50 μg投与群は10例中1例に2段階以上の改善を認めた.4)副作用は25例中4例に一過性の発熱および注射部位の紅斑・腫脹を認めた

Muroctasin, a derivative of muramyl dipeptide (MDP), increases WBC count through induction of the colony stimulating factor (CSF). This action of muroctasin is useful to treat cancer patients with leukopenia on chemotherapy. Urogenital cancer patients were randomized to either a 50 micrograms or 100 micrograms dose group of muroctasin when the WBC count dropped below 3, 000/cmm in the first cycle of chemotherapy. The patients were then subcutaneously treated with muroctasin once daily for 6 consecutive days, and restoration of their WBC count determined. Out of the 32 patients who were enrolled in the study, 25, 24 and 23 patients were assessed for safety, usefulness and efficacy, respectively. The 100 micrograms dose was more effective in restoring the WBC count than the 50 micrograms dose based on the evaluation by the physicians. This result was also confirmed when we used the criteria for evaluation of adverse reactions as recommended by the Japanese guidelines for evaluation of efficacy of chemotherapy on solid tumors. Mild fever and reaction at the injection site were noted in 16% (4/25). In conclusion, muroctasin is useful for leukopenia after chemotherapy.