Pharmaceutical Care on Pancreatic Cancer Chemotherapy-Appropriate Usage of G-CSF (granulocyte colony-stimulating factor) for Gemcitabine-induced Leukopenia-
Pharmaceutical Care on Pancreatic Cancer Chemotherapy-Appropriate Usage of G-CSF (granulocyte colony-stimulating factor) for Gemcitabine-induced Leukopenia-
复制标题
胰腺癌化疗药学监护-适当使用G-CSF（粒细胞集落刺激因子）治疗吉西他滨引起的白细胞减少-
DOI：
10.5649/jjphcs.29.391
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发表时间：
2003
期刊：
影响因子：
--
通讯作者：
K. Inui
中科院分区：
文献类型：
--
作者：
M. Onoue;Takako Kato;T. Terada;M. Okuda;H. Saito;K. Fujimoto;R. Doi;M. Imamura;K. Inui
胰腺癌是最难治的恶性肿瘤之一，手术、放疗和化疗均被广泛用于治疗。吉西他滨是一种治疗胰腺癌的新药，自2001年4月以来已被日本接受用于姑息治疗。对于药剂师来说，检查新药的不良反应非常重要，特别是在化疗药物的情况下，因为这些药物可能会表现出许多严重的不良反应，例如可能对患者致命的血液学毒性。在这项研究中，我们调查了吉西他滨的不良反应，以提高胰腺癌患者的药学服务。在一项不良反应调查中，在大多数患者中观察到严重的白细胞减少症。G-CSF（粒细胞集落刺激因子）通常用作白细胞减少症的治疗剂，其主要作用是刺激外周血中粒细胞谱系的增殖、分化和功能。另一个作用是使骨髓干细胞迁移到外周血中。由于后者的作用，建议G-CSF不应与化疗药物同时给药，并且应在化疗药物给药前后至少24小时停用。由于有一些患者在吉西他滨治疗后24小时内使用了G-CSF，我们向有关医生提供了关于G-CSF最佳使用的药物信息。结果，白细胞维持在正常水平，G-CSF的使用减少。总之，我们证实白细胞减少是吉西他滨治疗胰腺癌的主要不良反应
Pancreatic cancer is one of the most resistant malignancies and operations, radiotherapy and chemotherapy have all been widely used for the treatment of this disease. Gemcitabine, a new drug against pancreatic cancer , has been accepted for use in a palliative setting in Japan since April 2001. It is highly important for pharmacists to check for adverse effects of new drugs, especially in the case of chemotherapeutic agents, because these agents may exhibit many serious adverse effects such as hematologic toxicity that could be fatal to patients . In this study, we investigated the adverse effects of gemcitabine to improve the pharmaceutical care of patients with pancreatic cancer. In a survey of adverse effects, severe leukopenia was observed in most patients. G-CSF (granulocyte colony-stimulating factor) has been commonly used as a therapeutic agent for leukopenia, and its major principal action is to stimulate the proliferation, differentiation, and function of the granulocyte lineage in the peripheral blood. Another action is to cause marrow stem cells to migrate into the peripheral blood. Because of this latter action, it is advised that G-CSF should not be given concurrently with chemotherapeutic agents, and should be discontinued at least 24 hours before and after the administration of chemotherapeutic agents. Since there have been some patients in whom G-CSF was administered within 24 hors of gemcitabine treatment, we provided drug information about the optimal usage of G-CSF to doctors concerned . As a result, a normal level of leukocytes could be maintained, and the usage of G-CSF was decreased. In conclusion, we confirmed that leukopenia is the major adverse effect of gemcitabine in pancreatic cancer