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 Transplantation
Lawrence B FaulknerG Bernini

Abstract

The optimal dosing schedule of G-CSF for peripheral blood progenitor cell (PBPC) mobilization is still under investigation although many centers use 10 microg/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 microg/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, r2 = 0.4199). For ANC values above 5000/microl 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/microl or greater, the G-CSF serum level fell under the maximal in vitro stimulation threshold of 10 ng/ml within 12 h. This pre...Continue Reading

Citations

Apr 15, 2004·Pharmacological Research : the Official Journal of the Italian Pharmacological Society·Anne C Kotto-KomeDarlene A Calhoun
Aug 23, 2001·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·G GürmanH Koç
Sep 19, 2006·Nature Medicine·Nilesh M DagiaRobert Sackstein
Jul 9, 2014·Proceedings of the National Academy of Sciences of the United States of America·Cristina I Silvescu, Robert Sackstein
Dec 16, 2010·Pharmaceutics·Rong Shi, Hartmut Derendorf
Dec 25, 2012·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Becky J NataliMichael Liebl

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