ROLE OF GRANULOCYTE COLONY STIMULATING FACTOR (FILGRASTIM) IN CHEMOTHERAPY INDUCED FEBRILE NEUTROPENIC PATIENTS OF PEDIATRIC ACUTE LYMPHOBLASTIC LEUKEMIA

Dr Aditi Lingayat; Dr Rakesh Chikhlonde; Dr Amar Bise

Volume : VII, Issue : VI, June - 2018

ROLE OF GRANULOCYTE COLONY STIMULATING FACTOR (FILGRASTIM) IN CHEMOTHERAPY INDUCED FEBRILE NEUTROPENIC PATIENTS OF PEDIATRIC ACUTE LYMPHOBLASTIC LEUKEMIA

Dr Aditi Lingayat, Dr Rakesh Chikhlonde, Dr Amar Bise

Abstract :

AIMS & OBJECTIVES

Primary objectives: – 1.Role of granulocyte colony stimulating factor (filgrastim) in chemotherapy induced feile neutropenic patients of pediatric acute lymphoblastic leukemia i.e. primary outcome variables as resolution of fever and resolution of neutropenia. 2. To evaluate the secondary outcome variables such as duration of hospitalization and antibiotic usage with granulocyte colony stimulating factor (filgrastim) in chemotherapy induced feile neutropenic patients of pediatric acute lymphoblastic leukemia

Secondary objective: – 1.To study the adverse effects of filgrastim in chemotherapy induced feile neutropenic patients of pediatric acute lymphoblastic leukemia.

MATERIAL METHODS

This study done in government medical college and cancer hospital Aurangabad from January 2016 to August 2017. 100 chemotherapy induced feile neutropenic patients of pediatric ALL were included. Patients were admitted, detail history taken, examination done and all necessary investigations were done. Filgrastim was administered subcutaneously in a dose of 5 mcg/kg/day, for up to 2 weeks or until the ANC count reaches 1000 cell/cumm. After the administration of filgrastim, ANC level was measured daily and temperature was documented 6 hrly. Recovery of fever and resolution of neutropenia were considered as primary efficacy parameter, while duration of hospitalization and iv antibiotic usage were recorded as secondary efficacy variables. All clinically significant adverse effects after filgrastim administration were documented. All the necessary chemotherapy drugs were administered as per the protocol to treat these patients.

RESULTS

In present study most common age group affected was between 5 to 12 years (75%) and maximum number of cases were male (63%). Commonest symptom was fever (100%) followed by organomegaly (98%) and pallor (92%). Maximum number of patients (n = 54) received filgrastim for 3 days and maximum duration of filgrastim received was 7 days. Mean time for resolution of fever was 4.6 + 0.899 days and mean time for resolution of neutropenia was 2.23 + 0.75 days. Mean duration of hospitalization was 12.72 + 3.175 days and mean duration of IV antibiotics usage was 8.844 + 2.363 days. In present study most common adverse effect noted was bony pain(52%) followed by vomiting (30%) and headache (18%) of patients.

CONCLUSION

Filgrastim (G–CSF) is found to be effective in treatment of chemotherapy induced feile neutropenic patients of pediatric ALL and is safe in pediatric patients.