尿路移行上皮癌に対するMethotrexate,Etoposide,Cisplatinum併用療法でのRecombinant human granulocyte colony stimulating factorの臨床効果

Abstract

尿路移行上皮癌患者に於いてメトトレキセート, エトポシド及びシスプラチン(MEC)療法後, 組換人顆粒球コロニー形成刺激因子(rhG-CSF)を投与した。rhG-CSF 2μg/kgの皮下注射は, 白血球数が3000/mm3以下に減少した後(短期投与), 或いはMEC療法終了直後(予防的投与), にそれぞれ開始した。好中球数の最低値は, rhG-CSF非投与の対照群, 短期投与群, 及び予防的投与群でそれぞれ275±77, 250±317, 及び2066±47/mm3であった。好中球数が1000/mm3未満の日数は, 対照群, 短期投与群, 及び予防的投与群でそれぞれ6.6±0.6, 4±2, 及び0.9±0.5日であった。対照群と予防的投与群との間の差異は推計学的に有意であった

We determined the effective method of administration of recombinant human granulocyte colony-stimulating factor (rhG-CSF) in patients with transitional cell carcinoma of the urothelium receiving methotrexate, etoposide and cisplatinum (MEC) therapy. Recombinant human G-CSF was administered at 2 micrograms/kg subcutaneously starting after the white blood cell count was less than 3, 000/mm3 (short administration) or starting immediately after finishing MEC therapy (prophylactic administration). The median white blood cell nadir for the control group, short administration group and prophylactic administration group, was 275 +/- 77, 250 +/- 317 and 2, 066 +/- 47/mm3, respectively. The number of days with a white blood count of less than 1, 000/mm3 for the control group, short administration group and prophylactic administration group was 6.6 +/- 0.6, 4 +/- 2 and 0.9 +/- 0.5 days, respectively. The difference between the control group and prophylactic administration group was statistically significant (p < 0.01). These findings indicated that the prophylactic administration of rhG-CSF following MEC therapy was effective for preventing leukopenia. Other side effects of stomatitis, diarrhea and pneumonia were also decreased using rhG-CSF after MEC therapy.