Cov tshuaj Neuromax: cov lus qhia rau kev siv > Kev khomob thiab kev tiv thaiv

Filgrastim yog recombinant granulocyte colony stimulating factorCov. Yog ib muaj protein ntau tawm ntawm 175 amino acidsCov. Nws yog cais tawm los ntawm lub hlwb. Escherichia colirau hauv kev tshuaj ntsuam caj pa ntawm uas G-CSF tus neeg. Muaj cov kev ua lom tib G-CSFtsim nyob rau hauv tib neeg lub cev. Tsim kev kawm neutrophils thiab lawv tawm los ntawm cov pob txha pob txha. Nce ntxiv neutrophils hauv cov ntshav tau sau tseg tsis pub dhau 24 teev.

Kev ntsuas rau siv

neutropenia tom qab kev kho tshuaj,
ceev ceev CPMC hloov thiab cov neeg mob
neutropenia tom qab myeloablative kev kho mob ua ntej hloov hlwb pob txha,
idiopathic los yog congenital neutropenia nyob rau hauv cov neeg laus thiab cov menyuam yaus,
ua siab ntev neutropenia hauv cov neeg mob nrog HIV kis (nrog rau kev tsis muaj txiaj ntsig ntawm lwm txoj hauv kev ntawm kev kho mob).

Pharmacological kev txiav txim

Neupomax yog cov tshuaj tiv thaiv ntawm leukopoiesis. Neupomax muaj cov filgrastim, ib qhov ua haujlwm ntawm tib neeg granulocyte colony stimulating factor (G-CSF). Cov tshuaj yeeb dej caw muaj ib qho kev ua zoo ib yam li endogenous G-CSF; cov qauv tshuaj ntawm filgrastim txawv ntawm qhov kawg ntawm qhov sib txuas los ntawm N-davhlau ntxiv methionine seem (filgrastim yog protein tsis-glycosylated). Cov tshuaj tiv thaiv tau txais txiaj ntsig tau los ntawm kev siv DNA thev naus laus zis ntawm Escherichia coli hlwb, mus rau hauv lub tshuab tshuaj tua hluav taws xob uas cov gene tau tshaj tawm tias encode G-CSF cov protein.

Neupomax nce zus tau cov neutrophils nrog kev ua haujlwm zoo rau kev ua haujlwm, nrog rau lawv nkag mus rau hauv lub txaj vascular los ntawm cov hlwb pob txha. Neupomax muaj txiaj ntsig zoo hauv neutropenia ntawm ntau lub hauv paus pib.

Pharmacodynamics ntawm cov tshuaj Neupomax

Kev tswj hwm ntawm cov leeg thiab subcutaneous ntawm filgrastim ua rau muaj qhov cuam tshuam zoo ntawm nws cov theem. Qhov ntim xa tawm ntawm filgrastim ncav cuag 150 ml / kg.

Qhov txhais tau tias ib nrab-lub neej ntawm filgrastim yog 3.5 teev, qhov nruab nrab ntawm kev tshem tawm yog 0.6 ml / min / kg.

Filgrastim xyaum tsis suav (hauv cov neeg mob uas tau hloov kho pob txha hloov pob txha, uas tau txais cov tshuaj txuas ntxiv rau 28 hnub, tsis muaj cov cim ntawm tsub zuj zuj ntawm cov tshuaj).

Txoj kev ntawm daim ntawv thov

Neupomax yog npaj rau rau cov kev coj ua hauv tsev lossis kev coj ntawm lub cev. Kev daws yog muab txhua hnub subcutaneously lossis hauv daim ntawv ntawm luv infusions rau hauv cov hlab ntsha (txog 30 feeb). Yog tias tsim nyog, Neupomax raug tso cai raug tswj nyob rau hauv daim ntawv ntawm 24-teev tas li Txoj kev lis ntshav. Cov txheej txheem ntawm kev tswj hwm, nrog rau qhov ntau npaum li cas thiab kev siv sijhawm ntawm Neupomax daws, yog txiav txim los ntawm tus kws tshaj lij, suav txog qhov ntsuas thiab tus yam ntxwv ntawm tus neeg mob. Rau feem ntau cov neeg mob, kev coj noj coj ua yog qhov zoo dua.

Thaum muab cov tshuaj subcutaneously, nws raug nquahu kom hloov chaw txhaj tshuaj ntawm txhua qhov kev txhaj tshuaj (hloov chaw txhaj tshuaj txo qhov kev pheej hmoo ntawm kev mob siab tom qab kev siv tshuaj).

Muab cov Neupomax thaum siv tshuaj cytotoxic

Hauv kev siv tshuaj rau cov txheej txheem tshuaj, 5 μg / kg ntawm tus neeg mob lub qhov hnyav feem ntau yog sau tseg ib hnub ib zaug. Cov koob tshuaj no tau muab tshuaj txhua hnub subcutaneously lossis txhaj tshuaj rau ntawm txoj kev lis ntshav (txog 30 feeb) nrog kev soj ntsuam tas li ntawm daim duab ntshav. Cov tshuaj siv yog siv los ua kom tsis muaj neeg lub cev neutrophil.

Thawj qhov txhaj tshuaj ntawm filgrastim yog nqa tawm tsis dhau 24 teev tom qab kev ua tiav ntawm kev siv tshuaj kho mob. Lub sijhawm siv ntawm filgrastim yog txog 14 hnub. Muab hom kev siv tshuaj kho mob siv, tom qab sib txuam thiab induction kev kho mob ntawm cov mob khov kho ntawm myelogenous mob ntshav dawb, chav kawm ntawm kev siv tshuaj Neupomax tuaj yeem nce ntxiv mus rau 38 hnub. Hauv feem ntau ntawm cov neeg mob, qhov hloov pauv ntawm tus lej neutrophils tau sau rau ntawm hnub thib 2 - 3 ntawm kev kho mob filgrastim. Nws tsis pom zoo kom tsis txhob txiav cov kev kho qhov tseeb rau txog thaum lub cev neutrophil suav tau tom qab qhov kev npaj siab yuav txo qis ntawm cov ntsuas no (nrog kev tsis ua tiav ntawm kev kho, qhov zoo li ntawm tau txais kev kho mob ruaj khov yog txo). Kev kho nrog Neupomax raug txiav mus ntxiv yog tias muaj pes tsawg leeg ntawm neutrophils nce siab tshaj 10,000 / .l.

Muab cov Neupomax hauv txoj kev kho myeloablative nrog rau txoj kev hloov cov pob txha txuas ntxiv

Qhov pib hloov ntawm filgrastim rau kev kho mob myeloablative ua raws li los ntawm kev hloov chaw (kho mob lossis ib qho laj thawj) ntawm cov hlwb pob txha yog 10 μg / kg ntawm tus neeg mob hnyav. Cov tshuaj no tau muab tshuaj txhaj tshuaj rau qhov ntshav (lub sijhawm nrog kua yog 30 feeb lossis 24 teev). Nws tseem ua tau qhov qhia txog ntawm filgrastim los ntawm subcutaneous 24-teev Txoj kev lis ntshav.

Qhov pib siv ntawm Neupomax daws tau siv tsis pub dhau 24 teev tom qab kev ua tiav ntawm cytotoxic kev kho mob thiab tsis pub dhau 24 teev tom qab hloov pob txha.

Lub sijhawm li ntawm kev siv tshuaj Neupomax hauv kev kho mob myeloablative tsis yog ntau tshaj 28 hnub. Cov koob tshuaj niaj hnub ntawm filgrastim tuaj yeem hloov kho rau hauv tus account qib neutrophils thiab kev hloov pauv ntawm lawv cov lej. Thaum cov neutrophil suav tau ntau tshaj 1000 / μl rau peb hnub sib law liag, qhov ntau ntawm filgrastim yog txo mus rau 5 μg / kg ntawm tus neeg mob lub cev ib hnub. Yog tias, tom qab hloov kho koob tshuaj, qib neutrophil ntau dua 1000 / μl rau peb hnub sib law liag, Neupomax daws tau lawm. Yog tias, tom qab hloov cov koob tshuaj lossis tso tseg qhov kev daws Neupomax, tus lej ntawm neutrophils txo qis dua qis dua 1000 / μl, koj yuav tsum rov qab mus rau yav dhau los ntawm filgrastim.

Tsuas tshuaj ntawm Neupomax thaum lub sij hawm khiav ceev ntawm peripheral ntshav qia hlwb nyob rau hauv cov neeg mob uas muaj kab mob siab

Txhawm rau npaj cov peripheral ntshav qia hlwb, cov neeg mob uas muaj cov kab mob siab tau kho 10 μg / kg ntawm lub cev hnyav ib hnub subcutaneously bolus lossis subcutaneous infusion (rau 24 teev) rau 6 hnub sib law liag. Tawm tsam keeb kwm yav dhau los ntawm kev siv tshuaj filgrastim, 2 leukapheresis tau ua hauv kab (feem ntau yog nyob rau hnub 5 thiab 6 ntawm kev kho mob). Yog tias xav tau cov leukapheresis ntxiv, cov thawj coj ntawm filgrastim yuav tsum txuas ntxiv mus kom txog thaum kawg ua tiav tus txheej txheem no.

Kev noj tshuaj ntawm Neupomax tom qab kev kho mob myelosuppressive los npaj cov qe ntshav tawm ntawm cov hlwb

Tom qab ua qhov kev kho mob myelosuppressive, filgrastim feem ntau yog kho ntawm koob tshuaj 5 μg / kg ntawm tus neeg mob lub cev hnyav hauv daim ntawv los ntawm kev txhaj tshuaj. Kev Kho Mob nrog Neupomax pib hnub tom qab kawg ntawm kev siv tshuaj kho mob. Lub sijhawm siv ntawm filgrastim yog txiav txim siab los ntawm theem ntawm neutrophils thiab qhov hloov pauv ntawm lawv tus naj npawb; nws raug nquahu kom siv cov Neupomax npaj mus txog thaum tsis muaj nuj nqis ntawm qib neutrophil. Leukapheresis yog nqa tawm tom qab mus txog qib siab neutrophil ntau dua 2000 / μl.

Muab cov Neupomax rau kev nthuav cov peripheral ntshav qia hlwb hauv pub cov neeg noj qab haus huv zoo rau lub hom phiaj ntawm allogeneic hloov

Cov pub khoom noj qab haus huv tau qhia kom tswj cov filgrastim ntawm koob tshuaj 10 mcg / kg lub cev hnyav hauv ib hnub. Lub sijhawm ntawm chav kawm yog 4-5 hnub, thaum lub sijhawm 1-2 leukapheresis tso cai rau koj kom tau 4 * 106 CD34 + hlwb / kg ntawm tus neeg hnyav. Tsis muaj cov ntaub ntawv hais txog kev nyab xeeb ntawm kev siv filgrastim hauv cov nyiaj pub dawb hauv lub hnub nyoog 16 thiab tshaj 60 xyoo.

Dosage ntawm cov tshuaj Neupomax hauv mob nyhav neutropenia

Nrog rau daim ntawv sib deev ntawm neutropenia, filgrastim yog tshuaj ntawm 12 μg / kg ntawm tus neeg mob hnyav ib hnub, nrog idiopathic thiab periodic neutropenia, filgrastim yog tshuaj ntawm 5 μg / kg ntawm lub cev qhov hnyav ib hnub. Hauv cov xwm txheej zoo li no, cov tshuaj Neupomax raug muab tshuaj subcutaneously, koob tshuaj txhua hnub tuaj yeem faib ua ntau qhov kev txhaj tshuaj lossis muab tshuaj rau ib lub sijhawm. Kev kho yuav tsum ua txuas mus kom txog rau thaum qhov chaw ruaj khov neutrophil ntau dua 1500 / μl tau mus txog. Tom qab tau txais tus naj npawb tsim nyog ntawm neutrophils, nws yog qhov tsim nyog yuav tsum xaiv ib qho kev txhawb nqa tsawg kawg ntawm filgrastim, uas yuav ua kom paub tseeb tias cov naj npawb ntawm neutrophils tswj ntawm ib qib.

Muab tus neeg mob cov lus teb rau filgrastim kev kho, tom qab 1-2 lub lis piam tuaj yeem txo lossis nce ntxiv los ntawm 2 zaug. Ntxiv kev hloov kho koob tshuaj yog tau ua tiav 1 zaug hauv 1-2 lub lis piam. Cov koob tshuaj zoo tshaj plaws tau txiav txim siab tso cai rau theem ntawm neutrophils kom raug tswj nyob rau hauv txoj kev hauv tsev ntawm 1500-10000 / .l. Hauv kev kis mob hnyav, qhov nce ntxiv ntawm qhov hno ntawm filgrastim yog tso cai.

Kev nyab xeeb ntawm kev kho mob mus ntev nrog filgrastim nyob rau hauv cov tshuaj txhua hnub ntau dua 24 mcg / kg / hnub hauv cov neeg mob uas muaj mob ntev ntawm cov neutropenia tsis tau raug pov thawj.

Neupomax muab tshuaj rau neutropenia hauv cov neeg mob uas mob HIV

Qhov pib siv ntawm filgrastim rau cov neeg mob HIV thiab neutropenia yog 1-4 μg / kg ntawm lub cev hnyav ib hnub. Cov tshuaj yuav tsum tau nkag rau kom tau txais ib theem ib txwm ntawm neutrophils. Nyob ntawm qhov kam rau ua ntawm filgrastim thiab qhov muaj zog ntawm qhov nce ntawm neutrophils, cov koob tshuaj ntawm Neupomax daws tuaj yeem raug ntxiv. Tsis txhob siv ntau dua 10 mcg / kg ntawm tus neeg mob lub cev ib hnub.

Kev noj tshuaj ntawm Neupomax hauv qee pawg ntawm cov neeg mob

Rau cov menyuam hnub nyoog qis dua 16 xyoo, filgrastim yog tau txhaj rau cov koob tshuaj uas tau pom zoo rau cov laus. Qhov muab xam ntawm cov koob tshuaj ntawm filgrastim hauv kev kho mob hauv plab yuav tsum tau ua nyob ntawm qhov hnyav thiab qhov muaj zog ntawm qib neutrophils.

Cov neeg laus cov laus tsis tas yuav hloov koob tshuaj Neupomax.

Cov lus pom zoo rau qhov dilution ntawm Neupomax

Thaum muab tshuaj subcutaneously, Neupomax tsis meej.

Rau qhov kev npaj ntawm kev daws teeb meem rau kev tswj hwm drip, tsuas yog siv 5% dextrose kev daws teeb meem yuav tsum tau siv. Nws yog txwv tsis pub siv 0.9% sodium chloride (kev daws teeb meem yog tsis haum).

Nws yuav tsum tau yug los hauv lub siab tias cov tshuaj Neupomax ntawm kev saib xyuas ntawm 2-15 μg / ml tuaj yeem nqus tau los ntawm polymers thiab iav. Txhawm rau tiv thaiv qhov nqus ntawm filgrastim los ntawm cov phab ntsa ntawm lub vial, nws raug nquahu kom ntxiv cov tib neeg cov ntshav albumin los daws (qhov kawg ntawm cov tshuaj albumin hauv cov tshuaj pleev yuav tsum yog 2 mg / ml). Yog tias qhov kev txiav txim siab kawg ntawm filgrastim ntau tshaj 15 μg / ml, qhov sib ntxiv ntawm albumin tsis tas yuav. Kev txiav txim siab ntawm cov tshuaj Neupomax rau qhov kev txiav txim siab tsawg dua 2 μg / ml yog txwv tsis pub.

Cov lus qhia tshwj xeeb rau kev siv tshuaj Neupomax

Filgrastim txoj kev kho tsuas yog ua los ntawm tus kws tshaj lij uas muaj kev paub txog kev siv lub sijhawm ua haujlwm hauv lub plab, thiab ua rau muaj cov khoom uas yuav tsum muaj kev kuaj mob. Kev hloov mus los ntawm tes thiab apheresis yuav tsum tau nqa tawm tshwj xeeb hauv cov tsev kho mob tshwj xeeb.

Cov neeg mob uas mob neutropenia mob nyhav yuav tsum ua tib zoo soj ntsuam kev kuaj mob sib txawv ua ntej pib kev kho mob rau txoj kev kho mob kom tsis suav nrog lwm txoj kev kho mob hematological (suav nrog kev mob ntshav qab zib, mob ntshav qab zib myelogenous leukemia, myelodysplasia). Ua ntej pib txoj kev kho, nws yog ib qhov tsim nyog los ua kev soj ntsuam cytogenetic thiab morphological ntawm cov leeg pob txha.

Neupomax txoj kev kho yog ua tau tsuas yog nrog kev saib xyuas tas nrho cov duab ntawm cov ntshav nruab nrog nrog qhov yuav tsum tau xam ntawm cov leukocyte mis thiab cov ntshav platelet (thawj kev soj ntsuam tau ua ua ntej filgrastim yog siv, tom qab ntawd nws rov ua tsawg kawg 2 zaug hauv ib lub lis piam nrog kev kho mob thiab tsawg kawg 3 zaug hauv ib lub lis piam nrog kev nthuav dav ntawm cov qog peripheral ntshav cov ntshav). Yog tias filgrastim yog siv los ua kom muaj cov qe ntshav hauv lub cev, nrog kev nce ntxiv ntawm cov ntshav dawb ntawm ntau tshaj 100,000 / µl lossis txo qis hauv cov ntshav platelet tsawg dua 100,000 / µl, Neupomax yuav tsum tau muab tshem tawm lossis cov koob tshuaj filgrastim yuav tsum tau txo. Nws yuav tsum tau yug los rau hauv lub siab tias Cov Tshuaj Neupomax tsis tiv thaiv qhov tshwm sim ntawm anemia thiab thrombocytopenia cuam tshuam nrog myelosuppressive chemotherapy.

Tsis muaj pov thawj ntawm cov nyhuv ntawm filgrastim rau ntawm cov ntoo txuas piv rau cov neeg ua haujlwm tiv thaiv.

Nws yog ib qho tsim nyog yuav tsum tau soj ntsuam tas li ntawm kev soj ntsuam cov zis thaum kho nrog Neupomax (kom tsis suav nrog proteinuria thiab hematuria).

Nws raug nquahu los saib xyuas lub xeev morphological ntawm tus hnoos qeev thaum kho nrog Neupomax.

Nws yog qhov tsim nyog los tswj lub ntom thiab cov qauv ntawm cov pob txha pob txha hauv cov neeg mob concomitant pob txha pathology lossis pob txha tawg thaum kho mob ntev nrog Neupomax.

Sab sij huam

Tawm tsam keeb kwm ntawm kev kho nrog Neupomax tshuaj nyob rau hauv cov neeg mob, cov tsos ntawm tsis muaj qhov xav tau yog qhov ua tau:

Cov leeg mob ua ke: mob pob qij txha, mob leeg nqaij, mob pob txha, txha pob txha.
Lub plab zom mov: muaj kab mob hepatomegaly, tso quav tsis haum, tsis nco qab, ntuav, xeev siab.
Cov ntshav cov ntshav: leukocytosis, neutrophilia, thrombocytopenia, ntshav liab, ua kom loj thiab tawg ntawm tus po.
Kev ua pa tawm: mob ua pa nyuaj siab ntsws, ntsws ntsws txeem tawm.
CVS: ntshav siab lability, vasculitis.
Kev kuaj pom: nce (thim rov qab) theem ntawm uric acid, lactate dehydrogenase, gamma glutamyl transferase thiab alkaline phosphatase nyob rau hauv cov ntshav ntshiab, transient hypoglycemia (tom qab noj mov).

Tsis tas li ntawd, thaum kho nrog Neupomax daws, kev txhim kho ntawm proteinuria thiab hematuria, asthenia, qaug zog ntau dua, petechiae, ntswg thiab erythema nodosum tau sau tseg hauv qee cov neeg mob.

Thaum siv cov tshuaj Neupomax, cov neeg mob tuaj yeem yuav muaj kev tiv thaiv tsis haum nyob rau hauv daim ntawv ntawm lub ntsej muag, urticaria, ua pa tsis ua hauj lwm, arterial hypotension, thiab tachycardia.

Kev txhim kho ntawm cov mob hnyav ntawm cov mob myeloid leukemia thiab myelodysplastic syndrome nyob rau hauv cov neeg mob uas tau hais tawm ntawm cov leeg mob neutropenia tau sau tseg. Kev sib txuas lus ncaj qha ntawm cov kab mob nrog kev kho filgrastim tseem tsis tau muaj pov thawj, txawm li cas los xij, Neupomax yuav tsum tau kho rau cov neeg mob uas muaj mob loj neutropenia tsuas yog nrog morphological thiab kev soj ntsuam cytogenetic ntawm tus mob pob txha (tsawg kawg ib zaug txhua 12 lub hlis). Nrog txoj kev txhim kho cytogenetic hloov hauv cov pob txha pob txha, kev pheej hmoo thiab cov txiaj ntsig tau ntawm kev kho mob ntxiv nrog filgrastim yuav tsum raug txheeb xyuas thiab txoj kev xaiv tsis txiav Neupomax tshuaj yuav tsum raug txiav txim siab.

Kev tsim kho cov roj ntsha tiv thaiv ntshav thiab MDS xav tau kev txiav tawm ntawm Neupomax.

Neupomax tsis nce lub zaus thiab qhov mob ntawm cov tshwm sim tsis zoo ntawm cov tshuaj cytotoxic.

Filgrastim tuaj yeem ua rau muaj qhov nce ntxiv ntawm cov neeg mob hlwb, uas yuav tsum tau txiav txim siab thaum kho mob ntawm cov neeg mob uas muaj cov kab mob ntsws.

Cov Yuav Tsum Muaj

Neupomax tsis raug xaj rau cov neeg mob uas tsis txaus siab rau kev ua haujlwm rau filgrastim lossis ntu sib xyaw ntawm kev daws.

Neupomax tsis yog siv rau hauv kev kho mob rau cov neeg mob uas muaj mob loj rau lub cev nqaij daim tawv (Costmann syndrome) thiab cytogenetic ntshawv siab.

Neupomax tsis tuaj yeem siv los nce ntxiv ntawm cov kev siv tshuaj cytotoxic ntau dua li cov tshuaj pom zoo.

Qhov yuav tsum tau ceev faj thaum siv Neupomax tshuaj rau cov neeg mob tsis zoo thiab cov kab mob ntawm cov ntshav hu ua myeloid (nrog rau mob ntshav myelogenous leukemia), zoo li muaj cov kab mob hlwb mob hlwb ntau.

Tsis muaj ntaub ntawv qhia txog kev nyab xeeb ntawm filgrastim hauv cov neeg mob nrog autoimmune neutropenia.

Cev xeeb tub

Kev nyab xeeb ntawm kev kho nrog filgrastim ntawm cov poj niam cev xeeb tub tsis yog tsim muaj. Nws yog ib qho tsim nyog yuav tsum tau ua qhov kev soj ntsuam kom zoo txog cov kev pheej hmoo thiab cov txiaj ntsig ua ntej sau ntawv Neupomax rau cov poj niam thaum cev xeeb tub.

Tsis muaj ntaub ntawv qhia txog kev nkag mus ntawm Neupomax mus rau hauv niam mis. Nws yog qhov yuav tsum tau ua kom tiav kev pub niam mis ua ntej pib kho nrog Neupomax.

Yeeb tshuaj sib cuam tshuam

Kev nyab xeeb ntawm kev siv filgrastim tsis yog qhov tseeb tau muab coj los ua ke nrog myelosuppressive cytotoxic tshuaj uas siv hauv kev siv tshuaj kho mob (thaum cov tshuaj no siv rau tib hnub).

Muaj pov thawj ntawm kev nce ntxiv hauv qhov hnyav ntawm neutropenia thaum siv filgrastim thiab 5-fluorouracil.

Kev siv ua ke ntawm filgrastim nrog lwm cov kev loj hlob hematopoietic, nrog rau cytokines, tseem tsis tau kawm.

Nws yog ua tau kom nce qhov kev ua tau zoo ntawm filgrastim thaum ua ke nrog lithium npaj (lithium npaj txhawb kev tso tawm neutrophils).

Neupomax daws tsis sib haum nrog 0.9% sodium chloride.

Cia rau cov neeg mob

Neupomax yuav tsum muab cia kom txog qhov chaw ncav cuag ntawm cov menyuam ntawm qhov kub ntawm 2-8 degrees Celsius.

Nws yog txwv tsis pub khov rau cov tshuaj.

Txee lub neej yog 2 xyoos.

Tom qab qhib lub raj mis, cov tshuaj tsis tuaj yeem khaws cia.

Granogen, Zarsio, Immugrast, Leukostim, Leucite, Myelastra, Neutrostim, Tevagrastim, Filgrastim, Filergim.

Daim ntawv noj tshuaj:

kev daws rau cov tub ceev xwm thiab subcutaneous cov thawj coj.

1 ml ntawm cov tshuaj muaj:

cov tshuaj heev: filgrastim 300 mcg (30 lab units)

zam txim: glacial acetic acid, sodium hydroxide (sodium hydroxide), sorbitol (sorbitol), polysorbate 80, dej rau kev txhaj tshuaj.

Cov pob tshab los yog me ntsis opalescent, tsis muaj kob lossis kua xim ib nyuag.

Cov chaw muag tshuaj

Cov Tshuaj Hauv Tshuaj.

Cov tshuaj nquag ntawm cov yeeb tshuaj yog filgrastim - ib qho kev ua kom zoo ntawm tib neeg granulocyte colony stimulating factor (G-CSF). Filgrastim muaj tib txoj kev ua haujlwm lom neeg li cov neeg endogenous G-CSF, thiab sib txawv ntawm qhov tom kawg tsuas yog tias nws yog protein tsis-glycosylated nrog ib qho ntxiv N-terminal methionine residue. Filgrastim tau los ntawm kev ua kom muaj cov thev naus laus zis DNA thev naus laus zis yog cais los ntawm cov kab mob ntawm cov kab mob Esherichiacoli, lub cuab yeej kev tshuaj ntsuam ntawm kev qhia txog cov gene encoding protein G-CSF.

Filgrastim stimulates qhov tsim ntawm nquag lub cev neutrophils thiab lawv tso tawm rau hauv cov ntshav los ntawm cov hlwb pob txha; nws yog siv rau hauv kev kho mob ntawm cov neeg mob neutropenia ntawm ntau lub hauv paus pib.

Cov Tshuaj Pharmacokinetics

Ob qho tib si nrog cov tshuaj tso ntshav thiab subcutaneous ntawm filgrastim, pom qhov muaj txiaj ntsig zoo ntawm qhov nws cov ntshav ntawm lub koob tshuaj yog pom. Qhov ntim ntawm kev faib tawm hauv cov ntshav yog kwv yees li 150 ml / kg.

Qhov nruab nrab ib nrab-lub neej ntawm filgrastim los ntawm cov ntshav dej yog li 3.5 teev, thiab tus lej ntawm kev tshem tawm yog kwv yees li 0.6 ml / min / kg.

Kev tso dej tsis tseg ntawm cov ntshav paug mus txog 28 hnub rau cov neeg mob tom qab hloov hlwb pob txha tsis muaj cim nrog kev txhaws thiab nce ntxiv hauv ib nrab ntawm lub neej.

Sab sij huam

Los ntawm cov leeg musculoskeletal: mob hauv cov pob txha, cov leeg thiab pob qij txha, txha txha pob txha.

Los ntawm lub plab zom mov: anorexia, raws plab, mob hepatomegaly, xeev siab thiab ntuav.

Kev ua xua tsis haum: daim tawv nqaij ua pob, urticaria, o ntawm lub ntsej muag, hawb pob, ua pa luv, txo qis ntshav siab, tachycardia.

Los ntawm cov kabmob hemopoietic: neutrophilia thiab leukocytosis (vim yog lub txiaj ntsig pharmacological kev ua ntawm filgrastim), ua kom mob ntshav khov, mob ntshav thiav, mob plab, ua kom mob thiab txhaws ntawm qhov hnoos qeev.

Los ntawm tus txheej txheem ua pa: cov neeg laus ua pa nyuaj siab ntsws, mob ntsws nkag mus.

Los ntawm cov kab mob plawv: txos lossis nce ntshav siab, cov tawv nqaij vasculitis.

Los ntawm ntsuas ntsuas: thim rov qab nce ntxiv hauv cov ntsiab lus ntawm lactate dehydrogenase, alkaline phosphatase, gamma-glutamyltransferase, uric acid, hloov ntshav hypoglycemia tom qab noj mov, tsis tshua muaj: proteinuria, hematuria.

Lwm yam: mob taub hau, qaug zog, feem ntau qaug zog, txhaws ntswg, petechiae, erythema nodosum.

Filgrastim tsis nce qhov tshwm sim ntawm kev phiv tshuaj ntawm kev kho cytotoxic.

Kev cuam tshuam nrog lwm yam tshuaj

Qhov kev nyab xeeb thiab ua haujlwm ntawm filgrastim kev tswj hwm nyob rau tib hnub uas yog cov tshuaj myelosuppressive antitumor tsis tau tsim.

Muaj cov ntawv tshaj tawm txawv ntawm qhov muaj zog ntau ntxiv ntawm neutropenia thaum lub sijhawm teem ntawm filgrastim thiab 5-fluorouracil.

Tam sim no tsis muaj pov thawj los ntawm kev muaj kev cuam tshuam nrog lwm qhov kev loj hlob hematopoietic thiab cytokines.

Lithium, uas simulates tso cov neutrophils, tuaj yeem txhim kho cov nyhuv ntawm filgrastim.

Cov tshuaj lag luam cuam tshuam nrog 0.9% chloride tov.

Cov lus qhia tshwj xeeb

Neypomaksom kev kho mob yuav tsum tau ua tsuas yog nyob ntawm kev saib xyuas ntawm kws kho mob nrog kev paub dhau los siv kev siv colony stimulating yam, nrog kev tsim nyog muaj peev xwm kuaj mob. Kev hloov ntawm tes thiab kev ua apheresis yuav tsum tau nqa tawm hauv cov tsev kho mob tshwj xeeb.

Cov kev nyab xeeb thiab kev ua haujlwm ntawm filgrastim rau cov neeg mob myelodysplastic syndrome thiab mob myelogenous mob ntshav tsis tau tsim, thiab vim li no nws tsis pom zoo siv filgrastim rau cov kab mob no. Kev saib xyuas tshwj xeeb yuav tsum tau them rau qhov kev kuaj mob sib txawv ntawm tus mob ntshav txha caj qaum txhaws txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau xau txha caj dab ntev.

Ua ntej kev teem sijhawm Neupomax nyob rau hauv cov neeg mob uas muaj mob neutropenia (TCH), kev kuaj mob txawv yuav tsum ua tib zoo ua kom tsis suav lwm yam kab mob ntshav xws li mob ntshav tsis txaus, myelodysplasia, thiab mob myelogenous leukemia (morphological thiab cytogenetic tsom ntawm pob txha pob txha yuav tsum tau ua ua ntej kev kho mob).

Nrog rau kev siv cov filgrastim hauv cov neeg mob CTN, tau muaj tus mob ntawm kev txhim kho ntawm myelodysplastic syndrome thiab mob myeloid tawv nqaij tsis huv. Txawm hais tias qhov tseeb hais tias kev sib txuas ntawm txoj kev loj hlob ntawm cov kabmob no nrog kev siv cov filgrastim tseem tsis tau tsim, cov tshuaj yuav tsum tau siv nrog TCH nrog kev ceev faj ntawm kev tswj hwm morphological thiab cytogenetic ntawm tus mob pob txha (1 lub sijhawm hauv 12 lub hlis). Thaum cytogenetic txawv txav hauv pob txha pob txha, qhov kev pheej hmoo thiab muaj txiaj ntsig ntawm kev kho ntxiv nrog filgrastim yuav tsum ua tib zoo ntsuas. Nrog kev txhim kho MDS lossis mob roj ntsha daj, Neupomax yuav tsum tau txiav tawm.

Kev kho mob Neupomax yuav tsum tau ua nyob rau hauv kev saib xyuas ib txwm muaj los ntawm kev saib xyuas cov ntshav dav dav nrog lub leukocyte suav thiab platelet suav (ua ntej pib kho thiab tom qab ntawd 2 zaug hauv ib lub lis piam nrog kev kho mob txheem thiab tsawg kawg 3 zaug hauv ib lub lis piam nrog kev nthuav tawm ntawm PSCC nrog lossis tsis muaj tus mob pob txha txuas ntxiv). Thaum siv Neupomax los npaj PSCC, cov tshuaj yuav raug muab tso tseg yog tias muaj leukocytes ntau tshaj 100,000 / μl. Nrog lub platelet ruaj khov suav tsawg dua 100,000 / μl, nws raug nquahu kom tsum tsis txhob ua txoj kev kho tus mob pliag los yog txo nws cov koob tshuaj.

Filgrastim tsis tiv thaiv thrombocytopenia thiab ntshav liab vim myelosuppressive chemotherapy tsis ua haujlwm.

Thaum kho nrog Neupomax, yuav tso zis tso zis tsis tu ncua (kom tshem tawm hematuria thiab proteinuria) thiab qhov loj ntawm tus po yuav tsum tau saib xyuas.

Filgrastim yuav tsum tau siv nrog ceev faj hauv cov neeg mob uas muaj lub xov tooj ntawm tes mob caj dab hauv kev sib txuas nrog kev txhim kho kom tau ntawm kev tshaj tawm cov naj npawb ntawm cov neeg mob hlwb.

Kev nyab xeeb thiab kev ua tau zoo ntawm cov tshuaj hauv cov menyuam tshiab thiab cov neeg mob autoimmune neutropenia tseem tsis tau tsim.

Cov neeg mob uas muaj pob txha thiab ua pob txha txhawm rau tau txais kev kho mob tas li nrog Neupomax rau ntau tshaj 6 lub hlis tau qhia kev tswj ntawm pob txha lub cev.

Cov nyhuv ntawm filgrastim rau ntawm cov ntoo ntawm qhov sib piv tiv thaiv lub cev tiv thaiv tsis tau tsim.

Daim ntawv tso tawm.

Kev daws rau kev tswj hwm ntawm txoj leeg thiab subcutaneous, 300 μg (30 lab units) hauv 1 ml. Ntawm 1.0 ml (300 mcg, 30 lab units) lossis 1.6 ml (480 mcg, 48 lab units) hauv cov iav fwj, ntim nrog nres ntawm cov roj hmab sib xyaw nrog kev siv txhuas lub kaus mom.

5 fwj, ntim hauv ib pob contour ntawm PVC zaj duab xis ua ke nrog cov lus qhia rau kev siv, tau muab tso rau hauv pob ntawv los ntawm cov duab los qhia.

Yuav siv li cas: noj ntau thiab hom tshuaj kho

P / c lossis hauv daim ntawv luv luv ntawm qhov ua paug (tsis pub dhau 30 feeb), txhua hnub kom txog thaum tus naj npawb ntawm neutrophils ncav cuag qhov xav tias yuav tsum muaj yam tsawg kawg nkaus (nadir) thiab rov qab mus rau qhov qub. Cov tshuaj yog diluted nyob rau hauv ib tug 5% dextrose daws.

Txheeb ze s / c txoj kev ntawm kev tswj hwm tshuaj. Qhov kev xaiv ntawm txoj kev ntawm kev tswj hwm yog nyob ntawm cov xwm txheej kev kuaj mob tshwj xeeb.

Cov qauv kev kho mob cytotoxic: 0.5 lab units (5 mcg) / kg ib hnub ib zaug. Thawj cov tshuaj ntawm cov tshuaj yog muab tsis pub dhau 24 teev tom qab cytotoxic kev kho mob siv tshuaj. Lub sijhawm kho yog txog 14 hnub. Tom qab muab tso ua ke thiab kev kho kom zoo ntawm cov leeg mob myelogenous, lub sijhawm ntev ntawm kev kho tuaj yeem nce ntxiv mus txog 38 hnub, nyob ntawm seb hom, koob tshuaj, thiab cytotoxic chemotherapy kev kho mob siv. Ib qho hloov zuj zus hauv tus lej ntawm neutrophils feem ntau pom 1-2 hnub tom qab pib kho. Yuav kom ua tiav qhov kev kho kom ruaj khov, nws yog ib qho tsim nyog yuav tsum tau kho txuas ntxiv kom txog thaum tus naj npawb ntawm neutrophils dhau ntawm qhov kev cia siab yam tsawg kawg nkaus thiab nce mus txog qhov tseem ceeb. Nws tsis pom zoo kom thim cov tshuaj noj ua ntej lub sijhawm kom txog thaum muaj pes tsawg tus neutrophils hla dhau qhov xav tias yuav tsum tau ua. Txoj kev kho mob nres yog tias muaj tus naj npawb ntawm neutrophils tom qab nadir tau mus txog 1 txhiab / µl.

Tom qab myelo-ablative txoj kev kho, tom qab los ntawm kev hloov kho pob txha pob txha los yog allogeneic: hloov sc lossis iv infusion (hauv 20 ml ntawm 5% dextrose daws). Thawj koob tshuaj yog 1 lab units ntawm cov tshuaj (10 mcg) / kg hauv ib hnub hauv / hnoos lossis siv 30 feeb lossis 24 teev lossis los ntawm kev txaws txuas ntxiv li 24 teev. Thawj koob tshuaj yuav tsum siv tsis pub dhau 24 teev tom qab cytotoxic kev siv tshuaj kho mob, thiab nrog rau pob txha caj qaum hloov pauv - tsis pub dhau 24 teev tom qab pob txha mob pob txha. Lub sijhawm kho nrog tsis yog ntau tshaj 28 hnub. Tom qab qhov siab tshaj plaws nyob rau hauv tus naj npawb ntawm neutrophils (nadir), qhov koob tshuaj txhua hnub tau hloov kho nyob ntawm qhov muaj zog ntawm tus naj npawb ntawm neutrophils. Yog tias cov naj npawb ntawm neutrophils ntau dua 1 txhiab / forl rau 3 hnub sib law liag, qhov tshuaj txo qis rau 0.5 lab units / kg / hnub, tom qab ntawd yog tias tus naj npawb ntawm neutrophils ntau dua 1 txhiab / forl rau 3 hnub sib law liag, cov tshuaj yuav raug muab tso tseg. Yog tias nyob rau lub sijhawm kev kho mob tus naj npawb ntawm neutrophils txo qis dua 1 txhiab / μl, cov koob tshuaj tau nce siab dua raws li cov phiaj xwm tau muab.

Kev cog lus ntawm peripheral ntshav qia hlwb (PSCC) tom qab myelosuppressive txoj kev kho mob tom qab los ntawm kev hloov ntshav ntawm PSCC nrog lossis tsis hloov hlwb pob txha los yog hauv cov neeg mob myeloablative txoj kev kho mob tom qab hloov ntshav ntawm PSCC: 1 lab units (10 mcg) / kg ib hnub los ntawm kev ua ntu zus 24-teev s / c Txoj kev lis ntshav lossis s / c txhaj tshuaj 1 zaug hauv ib hnub rau 6 hnub sib law liag. Nws raug nquahu kom nqa tawm 3 leukapheresis hauv cov kab ua ke rau hnub thib 5, 6 thiab 7 hnub.

Kev ceev ntawm PSCA tom qab myelosuppressive kam rau ua: 0.5 lab units (5 μg) / kg ib hnub los ntawm kev txhaj tshuaj sc hnub txhua hnub, pib ntawm 1 hnub tom qab tshuaj tua kab mob tiav thiab kom txog thaum tus naj npawb ntawm neutrophils dhau ntawm qhov xav tias yam tsawg kawg nkaus thiab nce mus txog li qub qhov tseem ceeb. Leukapheresis yuav tsum tau ua nyob rau lub sijhawm thaum tus naj npawb tseeb ntawm neutrophils nce ntawm tsawg dua 500 mus rau 5 txhiab / μl. Rau cov neeg mob uas tsis tau txais tshuaj chemotreapia, tsuas yog tib zaug leukapheresis sib kho txaus. Hauv lwm qhov xwm txheej, nws raug pom zoo kom ua cov rooj sib tham ntxiv ntawm cov roj ntsha.

Kev ceev ntawm PSCC hauv kev pub noj qab haus huv rau kev hloov pauv allogeneic: s / c 1 lab units (10 μg) / kg / hnub rau 4-5 hnub muab tus lej CD34 + 4 lab / kg.

Mob leeg mob nyhav: niaj hnub sc, ib zaug lossis ob peb koob tshuaj. Nrog rau kev sib deev neutropenia, thawj koob yog 1.2 lab units (12 μg) / kg / hnub, nrog idiopathic lossis periodic neutropenia - 0.5 lab units (5 μg) / kg / hnub txog thaum nce siab ruaj khov ntawm tus lej neutrophils ntau tshaj 1500 / μl. Tom qab txoj kev kho kom ua tiav tiav, qhov txhaj tshuaj tsawg kawg yog txiav txim siab los tswj tus mob no, thiab kev tswj hwm ncua sijhawm ntev yuav tsum ua haujlwm. Tom qab 1-2 lub lis piam ntawm kev kho mob, thawj zaug tshuaj tuaj yeem tau ob npaug lossis txo qis 50%, nyob ntawm tus neeg mob teb rau kev kho. Tom qab, txhua 1-2 lub lis piam, koj tuaj yeem ua ib qho kev hloov kho ib leeg ib leeg kom tswj hwm tus lej ntawm neutrophils nyob hauv thaj tsam ntawm 1.5-10 txhiab / μl. Hauv kev kis mob hnyav, ib qho kev hloov pauv nrog ntau ntxiv nce ntxiv hauv koob tshuaj tuaj yeem siv tau. Hauv 97% ntawm cov neeg mob uas tau teb zoo rau kev kho mob, tag nrho cov txiaj ntsig kho tau pom nrog cov koob tshuaj ntau txog 24 mcg / kg / hnub. Qhov koob tshuaj txhua hnub yuav tsum tsis pub tshaj 24 mcg / kg / hnub.

Neutropenia hauv kev kis tus kabmob HIV: thawj koob tshuaj yog 0.1-0.4 lab units (1-4 )g) / kg / hnub ib zaug, s / c txhawm rau ua kom cov neutrophils ib txwm muaj. Qhov siab tshuaj ntau tshaj txhua hnub yog 10 mcg / kg. Qhov ib txwm ntawm cov naj npawb ntawm neutrophils feem ntau tshwm sim tom qab 2 hnub. Tom qab ua tiav cov txiaj ntsig kho, qhov tshuaj txij nkawm yog 300 mcg / hnub 2-3 zaug hauv ib lub lim tiam raws li lwm txoj kev hloov pauv. Tom qab, ib qho kev hloov kho ib tus neeg thiab kev tswj hwm lub sijhawm ntev ntawm cov tshuaj yuav raug tswj hwm tus naj npawb ntawm neutrophils ntau dua 2 txhiab / .l.

Hauv cov neeg laus cov neeg mob, tsis tas yuav txhaj tshuaj.

Cov lus pom zoo rau cov tshuaj ntawm cov menyuam yaus yog tib yam li rau cov neeg laus tau txais myelosuppressive chemotherapy.

Yog hais tias cov tshuaj yaj mus rau ib qho kev txiav txim siab ntawm tsawg dua 1.5 lab units (15 μg) / ml, ces tib neeg cov tshuaj albumin yuav tsum tau ntxiv rau qhov kev daws teeb meem kom kawg qhov kev txiav txim siab ntawm albumin yog 2 mg / ml (piv txwv, nrog kev daws zaum kawg ntim ntawm 20 ml, tag nrho cov tshuaj ntawm cov tshuaj tsawg dua 30 lab ED (300 μg) yuav tsum tau muab nrog 0.2 ml ntawm 20% kev daws ntawm tib neeg albumin. Koj tsis tuaj yeem nyem cov tshuaj mus rau qhov kawg qhov kev txiav txim siab ntawm tsawg dua 0.2 lab units (2 μg) / ml.

Neupomax, cov lus qhia rau kev siv (Txoj kev thiab ntau npaum li cas)

Feem ntau, cov tshuaj tau muab tshuaj txhua hnub subcutaneously, qee kis - mob hnyav (yaj tsuas yog hauv 5% kev daws dextrose) Kev xaiv ntawm txoj kev ntawm kev tswj hwm thiab kev noj tshuaj ntawm Neupomax nyob ntawm qhov xwm txheej kuaj mob. Cov txheej txheem kev kho mob yog qhov nyuaj heev, lawv muaj qhov sib txawv hauv cov kab mob sib txawv thiab lwm yam. Nov yog qee qhov ntawm lawv.

Tomqab kawm tas kev kho tshuaj teem 5 mcg / kg ib hnub ib s / c txhua hnub kom txog thaum tus kheej tso neutrophilsCov. Thawj koob tau txhaj tshuaj ib hnub tom qab thaum kawg kev kho tshuajCov. Lub sijhawm tiv thaiv yog txog li ob asthiv. Tom qab induction txoj kev kho mob huam myeloid kab mob ntshav siab lub sijhawm siv ntawm kev kho mob tuaj yeem ntev txog 38 hnub. Nce nyob rau hauv xov tooj neutrophils Nws tau sau tseg tom qab 1-2 hnub, txawm li cas los xij, kom ua tiav qhov tshwm sim ruaj khov, kev kho mob yuav tsum tsis txhob cuam tshuam.

Myeloablative kev kho mob ua ntej hloov pob txha

Txoj kev kho mob pib nrog 10 mcg / kg ib hnub, uas tau muab tso quav. Lub sijhawm tiv thaiv yog txog li 28 hnub.

Txoj kev mob siab CPMC hloov cov nyiaj - 10 mcg / kg 1 lub sijhawm hauv ib hnub, subcutaneously txog 5 hnub nrog kev tswj hwm ntxiv leukapheresis.

Txoj kev mob siab CPMC hauv cov neeg mob undergoing kev kho tshuaj - 5 mcg / kg ib hnub ib zaug, subcutaneously, txhua hnub kom txog thaum rov ua haujlwm neutrophils. Leukapheresis nqa tawm thaum neutrophils mus txog qhov tseem ceeb> 2000 / μl.

Neutropenia hauv cov neeg mob nrog HIV kis - 1-4 mcg / kg 1 sijhawm ib hnub, subcutaneously rau normalize qhov tseem ceeb neutrophilsCov. Tom qab ntawv thov rau hauv qhov kev saib xyuas txij nkawm - 3 mcg / kg txhua lwm hnub.

Cov Tshuaj Pharmacokinetics

Nrog rau ntawm / hauv thiab s / rau qhov kev qhia ntawm Neupomax, ib txoj hauv kev muaj txiaj ntsig ntawm qhov kev paub tseeb ntawm filgrastim ntawm koob tshuaj yog sau tseg.

Qhov ntim ntawm kev faib tawm tawm txog 150 ml / kg. Kev khaws av hauv av yog li 0.6 ml / min / kg.

Cov ntshav dej ib nrab-lub neej yog kwv yees li 3.5 teev.

Nrog kev txuas ntxiv Neupomax lub sijhawm dhau mus ntev txog 28 hnub, cov neeg mob uas tau hloov pob txha caj dab tsis tuaj yeem tsis muaj kev cuam tshuam txog ib nrab ntawm lub neej thiab kev tso zis ntawm cov tshuaj nquag.

Cov lus qhia rau kev siv Neupomax: txoj kev thiab ntau npaum li cas

Neupomax yog muab tshuaj sc rau hauv daim ntawv ntawm kev txhaj tshuaj lossis iv hauv daim ntawv ntawm luv luv 30-feeb infusions. Tsis tas li ntawd, yog tias tsim nyog, sc lossis mob tswj hwm yog ua tau rau hauv daim ntawv ntawm 24-teev infusions. Tus kws kho mob xaiv qhov zoo tshaj plaws txoj kev ntawm kev tswj hwm nyob ntawm cov kev soj ntsuam tshwj xeeb ntawm tus neeg mob, tab sis subcutaneous txoj kev ntawm kev tswj hwm pom tau tias zoo dua.

Txhua hnub, qhov chaw txhaj tshuaj yog pom zoo hloov pauv, qhov no yuav zam kev mob thaum lub sij hawm qhia txog cov tshuaj.

Cov kev cai rau kev npaj cov kev daws teeb meem:

Nrog kev tswj hwm subcutaneous, Neupomax tsis bred. Yog tias tsim nyog, Txoj kev lis ntshav raws li cov kuab tshuaj siv cov tshuaj ntawm dextrose 5%.
Vim tias cov kws tshuaj tsis sib xws, nws yog txwv tsis pub siv 0.9% sodium chloride tov rau kev daws teeb meem.
Diluted Neupomax ntawm qhov ntau ntawm 2–15 μg / ml tuaj yeem raug adsorbed yas thiab iav. Txhawm rau tiv thaiv kev nqus, nws yog ib qho tsim nyog yuav ntxiv tib neeg cov ntshiab albumin rau txoj kev daws teeb meem, nws cov koob tshuaj yog xam kom qhov tshuaj nyob hauv cov tshuaj kawg yog 2 mg / ml.
Albumin yuav tsum tsis txhob ntxiv rau diluted Neupomax ntawm ntau qhov siab dua 15 μg / ml.
Neupomax diluted nyob rau hauv ntau qhov tsawg dua 2 μg / ml yuav tsum tsis txhob siv.

Cov Qauv Kho Mob Cytotoxic

Qhov pom zoo koob tshuaj yog 5 mg rau ib kg ntawm lub cev qhov hnyav ib zaug ib hnub sc lossis iv nyob rau hauv daim ntawv ntawm luv luv 30-feeb infusion.

Thawj koob tshuaj yog muab tsis tau ua ntej 24 xuaj moos tom qab kawg ntawm kev kho mob cytotoxic.

Neupomax yog siv txhua hnub kom txog rau thaum, tom qab qhov xav tias yuav nce siab tshaj plaws nyob rau theem ntawm neutrophils, lawv tus lej tau rov zoo li qub, tab sis tsis tshaj 14 hnub. Tom qab ncav tau cov qauv, Neupomax tau raug muab tso tseg.

Lub sijhawm sijhawm ntawm txoj kev kho tuaj yeem nce ntxiv mus rau 38 hnub hauv cov neeg mob uas tau txais kev sib sau ua ke thiab qhov kev kho mob induction hauv kev sib txuas nrog cov mob ntshav myelogenous. Hauv qhov no, coj mus rau hauv tus account hom kev siv tshuaj kho cov tshuaj, nws hom thiab ntau npaum li cas.

Ib qho kev hloov pauv sai hauv tus naj npawb ntawm neutrophils feem ntau pom tau 1-2 hnub tom qab pib siv cov filgrastim. Txhawm rau kom ua tiav qhov ua kom lub cev ruaj khov, kev kho yuav tsum tsis txhob cuam tshuam kom txog thaum tsis muaj nqi neutrophil tom qab qhov xav tias yuav tsum txo tsawg hauv lawv tus lej. Nyob rau hauv qhov kev tshwm sim uas tus naj npawb ntawm neutrophils ntau tshaj 10,000 / μl, Neupomax raug tso tseg.

Mob Neutropenia Loj heev (TCH)

Thawj koob tshuaj txhua hnub yog: nrog rau sib deev neutropenia - 12 mcg / kg, nrog idiopathic lossis periodic neutropenia - 5 mcg / kg. Cov tshuaj tau muab s / c ib zaug lossis rau ob peb hnub, kom txog thaum tus naj npawb ntawm neutrophils ruaj khov dua 1500 / μl. Tom qab ua tiav cov nyhuv tsim nyog rau nws txoj kev khaws cia, Neupomax yog siv nyob rau hauv cov kev tswj xyuas qhov kev txiav txim siab ntawm tus kheej. Tom qab 1-2 lub lis piam ntawm kev kho, nyob ntawm tus neeg mob cov lus teb, cov tshuaj thawj zaug yog ob npaug lossis ib nrab.

Yav tom ntej, ib zaug txhua 1-2 lub lis piam, yog tias tsim nyog, yuav tau kho qhov tshuaj kho ib tus neeg kom nws ua rau koj tswj hwm qhov nruab nrab neutrophils nyob hauv thaj tsam li ntawm 1500 / tol txog 10,000 / μl.

Cov neeg mob uas muaj mob hnyav tuaj yeem kho tau raws li kev coj noj coj ua qhia tau hais tias nce siab dua.

Qhov kev nyab xeeb ntawm kev siv ntev ntev ntawm filgrastim hauv koob tshuaj txhua hnub ntau dua 24 mcg / kg hauv cov neeg mob TCH tseem tsis tau tsim.

Myeloablative kev kho mob tom qab hloov kho txoj kev hloov kho pob txha pob txha los yog allogeneic hloov hlwb

Txoj kev kho mob pib nrog ib koob tshuaj txhua hnub ntawm 10 mcg / kg. Neupomax yog muab tshuaj rau txoj kev mob sai li ntawm 30-feeb, Txoj kev lis ntshav ntev 24-teev lossis tso ntshav hla mus.

Thawj koob tshuaj tuaj yeem siv tau tsis pub dhau 24 teev tom qab qhov kawg ntawm kev qhia tshuaj cytotoxic, nyob rau hauv cov pob txha hloov mus rau pob txha - tsis pub dhau 24 teev. Lub sijhawm siv ntawm Neupomax yuav tsum tsis pub ntau tshaj 28 hnub.

Cov koob tshuaj txhua hnub tuaj yeem hloov kho nyob ntawm cov lej neutrophils tam sim no. Yog tias 3 hnub sib law liag tus naj npawb ntawm neutrophils ntau dua 1000 / μl, qhov tshuaj txhua hnub raug txo mus rau 5 μg / kg, thaum lub sijhawm 3 hnub tom qab thaum siv Neupomax hauv cov tshuaj no tus naj npawb ntawm neutrophils tsis poob qis dua 1000 / μl, cov tshuaj tau muab tso tseg. Yog tias muaj ib qho poob qis hauv neutrophils qis dua 1000 / μl, tom qab ntawd cov koob tshuaj tau nce ntxiv rau qhov qub.

Kev Txhim Kho ntawm Peripheral Ntshav Cov Qog Hlawv (PSCC) hauv cov Neeg Mob Mob Hlwb Pob

Cov koob tshuaj pom zoo yog 10 mcg / kg 1 lub sijhawm hauv ib hnub sc raws li kev txhaj tshuaj lossis txuas ntxiv nrog 24-teev Txoj kev lis ntshav. Cov tshuaj yaj yeeb siv tshuaj txhua hnub rau 6 hnub. Ntxiv mus, nyob rau hnub thib tsib thiab thib rau, leukapheresis feem ntau yog tshwm sim los. Yog tias muaj ntxiv los yog ntxiv leukapheresis qhia, kev qhia ntawm Neupomax txuas ntxiv mus kom txog rau thaum xaus ntawm cov txheej txheem kawg.

Kev ceev ntawm PSCC tom qab myelosuppressive kws khomob siv tshuaj

Neupomax yog muab tshuaj sc rau hauv daim ntawv ntawm txhua hnub.

Qhov pom zoo kom noj txhua hnub yog 5 mcg / kg. Thawj koob tshuaj yog muab rau hnub tom qab qhov kawg ntawm kev siv tshuaj kho mob, kev kho mob txuas ntxiv mus txog thaum muaj cov neutrophil suav tau mus txog.

Leukapheresis yog ua tau tsuas yog tom qab tus naj npawb ntawm neutrophils ntau dhau lub cim ntawm 2000 / μl.

HIV Neutropenia

Cov tshuaj yog muab sc. Txoj kev kho mob pib nrog txhaj tshuaj ib hnub twg ntawm 1-4 dailyg / kg thiab txuas ntxiv kom txog thaum muaj pes tsawg tus neutrophils tau ib txwm muaj. Qee qhov xwm txheej, nws muaj peev xwm nce ntxiv qhov koob tshuaj txhua hnub, tab sis tsis pub tshaj 10 μg / kg.

Tom qab ua tiav cov txiaj ntsig kho, qhov koob tshuaj ntawm Neupomax raug txo kom tsawg dua kev saib xyuas, uas feem ntau yog 300 mcg txhua lwm hnub.

Yav tom ntej, tus kws kho mob hloov cov tshuaj noj ib lub zuj zus rau txhua tus neeg mob kom cov koob tshuaj tau khaws cia nruab nrab cov lej neutrophils saum toj 2000 / µl.

Cev xeeb tub thiab lactation

Kev nyab xeeb ntawm filgrastim thaum nws siv thaum cev xeeb tub tseem tsis tau tsim, yog li ntawd, cov tshuaj yuav tau raug tsuas yog tau txais txiaj ntsig qhov txiaj ntsig yuav pom tseeb siab dua li cov kev pheej hmoo txaus ntshai.

Lub peev xwm ntawm filgrastim txhawm rau nkag rau niam mis tsis tau tsim, vim li no, kev teem sijhawm Neupomax tsis pom zoo thaum lub sijhawm lactation.

Kev txheeb xyuas ntawm Neypomaks

Raws li kev txheeb xyuas ntawm Neupomax, cov tshuaj tau hais tawm tsis tsuas yog rau cov neutropenia cuam tshuam nrog kev siv tshuaj kho mob, tab sis kuj tseem txo qis cov neutrophils nyob rau hauv cov ntshav vim muaj ntau lwm yam kab mob uas muaj mob loj autoimmune thiab oncological. Tsis tas li, kev siv cov filgrastim yog kev pom zoo rau kev kis tus kabmob HIV thiab tus mob muaj kab mob siab C rau cov neeg mob uas tau txais kev kho mob los tiv thaiv kab mob, nrog rau cov hluas mob rheumatoid.

Tsis hais txog ntawm qhov ntsuas, thaum thov Neupomax, kev nce sai sai ntawm neutrophils thiab leukocytes tau sau tseg, cov lus teb rau qhov kev xav tshwm sim tom qab txog 9 hnub. Txawm li cas los xij, cov neeg mob uas tau txais cov tshuaj tua kab mob los tiv thaiv, filgrastim yuav tsum siv ntev.

Nyias muaj nyias cov lus tsis txaus siab txog kev tsim cov kev mob tshwm sim, xws li ua daus no, mob pob txha thiab mob pob txha, ua npaws, qhov ncauj qhuav, thiab mob taub hau.

Yog li, Neupomax tau siv ntau zaus thiab ua tau zoo ntawm kev kho thiab tiv thaiv neutropenia.