Neupogen for Gleevec induced neutropenia – pro

Many chemotherapeutic drugs cause neutropenia and guidelines now uniformly recommend G-CSF(granulocyte growth stimulating factors) prophylactically and therapeutically for chemotherapy. However, non-chemo drugs can also cause neutropenia. Among them are bcr-abl directed drugs used for CML, such as Gleevec. Depending on the stage, up to 70% of the patients treated with imatinib for CML experience an NCI grade 3 or 4 neutropenia or thrombocytopenia during Imatinib therapy. A number of reports indicate that Neupogen can overcome neutropenia, allowing maintenence of dose and schedule of imatinib. NCCN in version 2.2013 recommends GSCF in combination with imatinib in patients with refractory neutropenia. In Asia beramine si being investigatede for this purpose.

Zaucha JM, Wyrowinska E, Prejzner W, Calbecka M, Hellmann A. Imatinib-associated neutropenia may not be overcome by filgrastim treatment in patients with blastic phase of chronic myeloid leukaemia.Clin Lab Haematol. 2006 Jun;28(3):208-10.

D Heim et al, G-CSF for Imatinib-induced neutropenia. Leukemia (2003) 17, 805–807.

nccn. org, CML 2012

Zhao Y, Tan Y, Wu G, Liu L, Wang Y, Luo Y, Shi J, Huang H. Berbamine overcomes imatinib-induced neutropenia and permits cytogenetic responses in Chinese patients with chronic-phase chronic myeloid leukemia.Int J Hematol. 2011 Aug;94(2):156-62.

 For Lay version see here

For Neupogen for interferon induced neutropenia see here

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