G-CSF serum pharmacokinetics during peripheral blood progenitor cell mobilization: neutrophil count-adjusted dosage might potentially improve mobilization and be more cost-effective (original) (raw)

Peripheral Blood Stem Cells

Bone Marrow Transplantation volume 21, pages 1091–1095 (1998)Cite this article

Abstract

The optimal dosing schedule of G-CSF for peripheral blood progenitor cell (PBPC) mobilization is still under investigation although many centers use 10 μg/kg/day in a single subcutaneous dose. However, G-CSF clearance increases with increasing absolute neutrophil count (ANC). Hence a G-CSF dosage adjusted to ANC might be a reasonable approach. We measured G-CSF trough serum levels by sandwich ELISA assay at different ANCs in eight patients undergoing treatment with filgrastim at 10 μg/kg/day in a single subcutaneous dose. A total of 26 samples were analyzed, and a strong correlation between increasing ANC and decreasing G-CSF levels was found by linear regression analysis (P < 0.0003, _r_2 = 0.4199). For ANC values above 5000/μl the trough serum levels, ie 24 h after administration, were consistently below the level that provides maximal clonogenic precursor stimulation in vitro (10 ng/ml). Serial serum G-CSF measurements performed in three patients at 0, 3, 6, 9 and 24 h after G-CSF administration, showed a reduction of the area under the curve (AUC) with increasing ANC. For an ANC of 20000/μl or greater, the G-CSF serum level fell under the maximal in vitro stimulation threshold of 10 ng/ml within 12 h. This preliminary pharmacokinetic data seems to suggest that an ANC-adjusted G-CSF dosing schedule might improve the design of PBPC mobilization regimens.

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Authors and Affiliations

  1. Department of Pediatrics, Hematology-Oncology Service and Blood Bank, University of Florence, Ospedale Pediatrico A Meyer, Florence, Italy
    LB Faulkner, F Tucci, A Tamburini, V Tintori, AA Lippi, F Bambi, F Malentacca, C Azzari, AMG Gelli, F Genovese & G Bernini

Authors

  1. LB Faulkner
  2. F Tucci
  3. A Tamburini
  4. V Tintori
  5. AA Lippi
  6. F Bambi
  7. F Malentacca
  8. C Azzari
  9. AMG Gelli
  10. F Genovese
  11. G Bernini

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Faulkner, L., Tucci, F., Tamburini, A. et al. G-CSF serum pharmacokinetics during peripheral blood progenitor cell mobilization: neutrophil count-adjusted dosage might potentially improve mobilization and be more cost-effective.Bone Marrow Transplant 21, 1091–1095 (1998). https://doi.org/10.1038/sj.bmt.1701241

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