The incidence and timing of leukocyte overshoot after pegfilgrastim administration

2018 ◽  
Vol 25 (4) ◽  
pp. 869-874 ◽  
Author(s):  
Eiseki Usami ◽  
Michio Kimura ◽  
Mina Iwai ◽  
Makiko Go ◽  
Hiroki Asano ◽  
...  
Keyword(s):  
Blood Cell ◽  
Cell Count ◽  
White Blood Cell Count ◽  
White Blood Cell ◽  
Reference Value ◽  
Granulocyte Colony Stimulating Factor ◽  
Colony Stimulating Factor ◽  
Blood Cell Count ◽  
Cell Counts ◽  
Stimulating Factor

Introduction Pegfilgrastim is a PEGylated formulation of filgrastim with a long half-life. It is highly convenient and less burdensome for patients. However, white blood cell count may temporarily increase after administration; in particular, a leukocyte overshoot may be observed. The present study retrospectively examined the incidence and timing of leukocyte overshoot after pegfilgrastim administration. Patients and methods Fifty-five patients (118 occasions of pegfilgrastim) were evaluated. Leukocyte overshoot was defined as white blood cell count ≥10,000/mm3 exceeding the reference value. Results Leukocyte overshoot was observed in 71.2% (84/118) occasions, in 76.4% (42/55) patients. The maximum white blood cell count ≥30,000/mm3 was observed in 30.5% (36/118) occasions in 45.5% (25/55) patients and was observed in 39.3% (33/84) occasions on day 1 after pegfilgrastim administration and 26.2% (22/84) on day 2. Leukocyte overshoot has been observed in only 23.1% (9/39) patients administered with normal granulocyte colony-stimulating factor. However, there were no patients with white blood cell counts ≥30,000/mm3. Conclusion There was a higher frequency of occurrence of leukocyte overshoot in response to pegfilgrastim than in response to normal granulocyte colony-stimulating factor. High incidence of leukocyte overshoot was observed when blood was collected 1–2 days after administration of pegfilgrastim. It is important for patients to understand the characteristics of pegfilgrastim by conducting pharmaceutical guidance.

Growth and reproductive traits of F1-generation transgenic goats for human granulocyte-colony stimulating factor

2018 ◽  
Vol 58 (7) ◽  
pp. 1218
Author(s):  
R. I. T. P. Batista ◽  
J. M. G. Souza-Fabjan ◽  
D. Í. A. Teixeira ◽  
L. M. Melo ◽  
V. J. F. Freitas
Keyword(s):  
Blood Cell ◽  
Cell Count ◽  
White Blood Cell Count ◽  
White Blood Cell ◽  
Reproductive Parameters ◽  
Granulocyte Colony Stimulating Factor ◽  
Colony Stimulating Factor ◽  
Blood Cell Count ◽  
Transgenic Lines ◽  
Stimulating Factor

To ensure that animal welfare requirements and phenotypic characteristics of the newly produced transgenic lines are not compromised, an evaluation of all individuals is necessary. This can be inferred by the analysis of the growth and reproduction parameters. The present study was designed to determine the impact of the insertion of human granulocyte-colony stimulating factor (hG-CSF) transgene on growth and reproductive characteristics in first-generation (F1) goats from two transgenic lines. Bodyweight (BW) development (BW at birth, mean BW gain before weaning, BW at weaning, mean BW gain after weaning, BW at puberty), as well as reproductive parameters (age at puberty, ejaculate volume, concentration, total sperm per ejaculate, massal motility, progressive individual motility, major and minor defects) were similar (P > 0.05) between transgenic (T) and non-transgenic (NT) goats. Significant (P < 0.05) differences in mean (±s.d.) white blood cell count were observed between T and NT in first day of life (174.6 ± 14.7 × 103 and 15.0 ± 4.0 × 103 cells/µL), and during (66.8 ± 21.1 × 103 and 17.0 ± 4.6 × 103 cells/µL) and after (36.6 ± 4.0 × 103 and 15.5 ± 2.2 × 103 cells/µL) suckling, even though hG-CSF has not been detected in blood serum in any analysis. Although other cell counts were occasionally higher in T animals, differential counts showed that this difference was mainly due to an increased number of neutrophils, which represents 84.6%, 67.2% and 56.8% of total white blood cell count respectively, in the three time periods. Kidney and liver biochemical analyses indicated that all goats were healthy. Thus, it is possible to assume that all animals are normal and had no deleterious effects on either growth or reproductive parameters by the presence of transgene or as a consequence of leukocyte profile alteration.

scholarly journals Granulocyte Colony-Stimulating Factor-Producing Bladder Cancer

2019 ◽  
Vol 12 (2) ◽  
pp. 603-607 ◽  
Author(s):  
Ryota Morinaga ◽  
Takashi Kawahara ◽  
Shinnosuke Kuroda ◽  
Yoshiaki Inayama ◽  
Hiroji Uemura
Keyword(s):  
Bladder Cancer ◽  
Blood Cell ◽  
Cell Count ◽  
Bladder Tumor ◽  
Resected Specimen ◽  
Granulocyte Colony Stimulating Factor ◽  
Colony Stimulating Factor ◽  
Blood Cell Count ◽  
Gross Hematuria ◽  
Stimulating Factor

Granulocyte colony-stimulating factor (G-CSF)-producing bladder cancer is rare, with only 75 cases reported in Japan. A 67-year-old woman was referred to our institution for the further examination of gross hematuria. Cystoscopy revealed a 7-cm bladder tumor. The initial white blood cell count was 17,100/μL, and a transurethral resected specimen showed G-CSF expression. CT revealed that the tumor had invaded the colon. As the patient had uncontrollable schizophrenia, radical cystectomy was abandoned. We herein report a case of G-CSF-producing bladder tumor.

scholarly journals White blood cell count and ratıo changes ın newborns after granulocyte colony-stımulatıng factor treatments

2021 ◽  
Vol 61 (5) ◽  
pp. 240-6
Author(s):  
Melek Buyukeran ◽  
Şule Yiğit ◽  
Hasan Tolga Çelik ◽  
Murat Yurdakök
Keyword(s):  
Blood Cell ◽  
White Blood Cell ◽  
White Blood Cells ◽  
Granulocyte Colony Stimulating Factor ◽  
Colony Stimulating Factor ◽  
Cell Counts ◽  
Before And After ◽  
Sepsis Marker ◽  
Complete Blood Counts ◽  
Stimulating Factor

Background Granulocyte-colony stimulating factor (G-CSF) is frequently used to treat neonatal neutropenia. There is a paucity of data in the literature on when immature to total neutrophil ratio (I/T ratio) can be accurately used as a sepsis marker after G-CSF therapy, as well as when I/T ratio returns to normal values expected in newborns who did not receive G-CSF. Objective To investigate changes in white blood cells counts and ratios in neonates with neutropenia before and after G-CSF therapy. Methods This retrospective study included newborns admitted to the NICU of Hacettepe University Ihsan Dogramaci Hospital, Ankara, Turkey, between 2005 and 2017 who received G-CSF therapy for neutropenia. Subjects underwent complete blood counts on the day before receiving G-CSF therapy (day 0) as well as days 1, 2, and 3 after treatment; I/T ratios were recorded from peripheral smears. Results Twenty-eight neonates were included in the study. Subjects’ median gestational age (interquartile range 25–75%) was 32.6 (29.7–37.6) weeks, and median birth weight was 1,630 (1,040–2,980) g. On day 3, there were significant increases in white blood cell counts compared to day 0. There were statistically significant elevations in the I/T ratios between day 0 and day 1 and between day 0 and day 2. On day 3, the I/T ratio decreased, but was not significantly different between day 0 and day 3. Conclusion The changes in I/T ratio observed after G-CSF treatments in our study suggest that the I/T ratio can be used as a reliable sepsis marker starting 72 hours after G-CSF administration. However, I/T ratio is significantly affected within 72 hours of G-CSF administration, and therefore, is unreliable as a sepsis marker during that period.

scholarly journals Ritodrine-Induced Agranulocytosis: A Case Report and Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Atsushi Daimon ◽  
Misa Nunode ◽  
Takumi Sano ◽  
Tomohito Tanaka ◽  
Daisuke Fujita ◽  
...  
Keyword(s):  
Blood Cell ◽  
White Blood Cell ◽  
Preterm Labor ◽  
Continuous Intravenous Infusion ◽  
Granulocyte Colony Stimulating Factor ◽  
Colony Stimulating Factor ◽  
Premature Labor ◽  
Blood Cell Count ◽  
Ritodrine Hydrochloride ◽  
Stimulating Factor

Ritodrine hydrochloride is used for preterm labor, although serious side effects, including agranulocytosis, are reported. We report a case of ritodrine hydrochloride-induced agranulocytosis accompanied by bacteremia due to catheter infection. At 24 weeks of gestation, a female patient presented due to threatened premature labor and was administered continuous intravenous infusion of ritodrine hydrochloride. On day 36 after starting intravenous ritodrine hydrochloride, she was diagnosed with agranulocytosis. The white blood cell and granulocyte count nadirs were 1,660/μl and 438/μl. The cumulative dose of ritodrine hydrochloride was 2,610 mg. Ritodrine therapy was immediately stopped, and she was given an intravenous injection of antibiotics and granulocyte colony-stimulating factor. From her blood culture, methicillin-sensitive Staphylococcus aureus was detected. However, she started vaginal delivery two days after we stopped the ritodrine infusion. When using ritodrine hydrochloride, it is necessary to frequently check the white blood cell count, regardless of the total dose and treatment period.

Value of white blood cell count with differential in the acute diabetic foot infection

1996 ◽  
Vol 86 (5) ◽  
pp. 224-227 ◽  
Author(s):  
DG Armstrong ◽  
TA Perales ◽  
RT Murff ◽  
GW Edelson ◽  
JG Welchon
Keyword(s):  
Blood Cell ◽  
Cell Count ◽  
White Blood Cell Count ◽  
White Blood Cell ◽  
Diabetic Foot ◽  
Polymorphonuclear Leukocyte ◽  
White Cell ◽  
Blood Cell Count ◽  
Diabetic Foot Infection ◽  
Cell Counts

The authors reviewed the admission leukocyte indices of 338 consecutive admissions (203 males, 135 females, mean age of 60.2 +/- 12.9 years) with a primary diagnosis of diabetic foot infection in a multicenter retrospective study. The mean white blood cell count on admission for all subjects studied was calculated at 11.9 +/- 5.4 x 103 cells/mm3. Of all white blood cell counts secured for patients admitted with a diabetic foot infection, 56% (189 out of 338) were within normal limits. The average automated polymorphonuclear leukocyte percentage was calculated at 71.4 +/- 11.1% (normal range 40% to 80%). Normal polymorphonuclear leukocyte values were present in 83.7% of subjects. The authors stress that the diagnosis of a diabetic pedal infection is made primarily on the basis of clinical signs and symptoms, and that a normal white cell count and white cell differential should not deter the physician from taking appropriate action to mitigate the propagation of a potentially limb-threatening pedal infection.

Agranulocytosis Induced by Vancomycin or Ticarcillin/Clavulanate

1997 ◽  
Vol 31 (11) ◽  
pp. 1321-1324 ◽  
Author(s):  
Delbert L Mandl ◽  
Mark W Garrison ◽  
Samuel D Palpant
Keyword(s):  
Blood Cell ◽  
Cell Count ◽  
White Blood Cell Count ◽  
White Blood Cell ◽  
White Blood Cells ◽  
Blood Cell Count ◽  
Cell Counts ◽  
Long Term Treatment ◽  
Term Administration

OBJECTIVE: To reacquaint clinicians with a reportedly rare adverse event of agranulocytosis occurring after long-term administration of vancomycin and ticarcillin/clavulanate, with a subsequent review of other reported cases in the literature. CASE SUMMARY: A 45-year-old white woman with spina bifida developed agranulocytosis (2.7 × 103/mm3 white blood cells with only 3% polymorphonuclear leukocytes and no reported eosinophils or basophils) after long-term administration of vancomycin and ticarcillin/clavulanate for decubitus ulcers and chronic osteomyelitis. Consequently, the cell counts rebounded rapidly on discontinuation of both medications and returned to normal within 1 week. DISCUSSION: The incidence of vancomycin-associated neutropenia is presumably rare, but the increased use of vancomycin may disclose a more frequent occurrence. It is suggested that the mechanism for the reaction is immunologically mediated, yet this remains unclear. Although it is difficult to determine the causative agent in this case, vancomycin was most suspect clinically. Ticarcillin/clavulanate is less likely because our patient has since been readmitted and treated with oxacillin, imipenem/cilastatin, and amoxicillin/clavulanate without affecting the white blood cell count. In that regard, it could be reasoned that an immunologic reaction to ticarcillin would have resulted in a similar outcome with other penicillins. CONCLUSIONS: This case serves as a reminder to clinicians that patients receiving long-term treatment with vancomycin should have their white blood cell count monitored at least weekly.

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