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This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Saven, A. Articles by Koziol, J. A. Search for Related Content PubMed PubMed Citation Articles by Saven, A. Articles by Koziol, J. A. Related Collections Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Blood, Vol. 93 No. 8 (April 15), 1999: pp. 2471-2477 Filgrastim for Cladribine-Induced Neutropenic Fever in Patients With Hairy Cell Leukemia Alan Saven, Carol Burian, Jasvant Adusumalli, and James A. Koziol From the Division of Hematology/Oncology, Ida M. and Cecil H. Green Cancer Center, Scripps Clinic, La Jolla, CA; and The Scripps Research Institute, La Jolla, CA. Cladribine treatment of hairy cell leukemia (HCL) is complicated by neutropenic fever in 42% of patients despite documented infections being relatively uncommon. We performed a study of priming filgrastim followed by cladribine and then filgrastim again to determine if filgrastim would lead to a reduction of neutropenia and febrile episodes. Thirty-five patients received filgrastim and cladribine and were compared with 105 historic controls treated with cladribine alone. Cladribine was administered at 0.1 mg/kg/d by continuous infusion for 7 days. Filgrastim was administered at 5 µg/kg/d subcutaneously on days 3, 2, and 1 and then again after the completion of cladribine until the absolute neutrophil count (ANC) was 2 × 109/L on 2 consecutive days (days +8, +9, etc). After filgrastim priming, the median ANC increased from 0.9 × 109/L to 2.26 × 109/L (2.5-fold increase), and after cladribine, the median nadir ANC in the filgrastim-treated group was 0.53 × 109/L compared with 0.29 × 109/L among historic controls (P = .04). The median number of days to an ANC greater than 1.0 × 109/L was 9 days in the filgrastim-treated group versus 22 days among historic controls (P < 105). The percentage of febrile patients, number of febrile days, and frequency of admissions for antibiotics were not statistically different in the two groups. Filgrastim regularly increases the ANC in patients with HCL and shortens the duration of severe neutropenia after cladribine. This phase II study, with comparison to historical controls, failed to detect any clinical advantage from the use of filgrastim and cladribine in the treatment of HCL. Accordingly, the routine adjunctive use of filgrastim with cladribine in the treatment of HCL cannot be recommended. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: G. R. Goodman, C. Burian, J. A. Koziol, and A. Saven Extended Follow-Up of Patients With Hairy Cell Leukemia After Treatment With Cladribine J. Clin. Oncol., March 1, 2003; 21(5): 891 - 896. [Abstract] [Full Text] [PDF]

	Copyright © 1999 by American Society of Hematology         Online ISSN: 1528-0020