Neuromax ea lithethefatsi: litaelo tsa tšebeliso

Filgrastim ke colombulant ea granulocyte colony e susumetsang. Is a protheine ho tsoa 175 amino acid. E ikhethile ho lisele. Escherichia colika har'a liphatsa tsa lefutso tseo G-CSF motho. E na le ts'ebetso e ts'oanang ea bioloe joalo ka G-CSFhlahisoang mmeleng wa motho. E hlohlelletsa thuto neutrophils le ho tsoa ha bona moko oa masapo. Eketsa neutrophils maling a bonoa ka nako ea lihora tse 24.

Matšoao a ho sebelisoa

neutropenia kamora chemotherapy,
ts'ebeliso CPMC bafani le bakuli
neutropenia kamora monelabilative kalafo pele ho phetisetso ea marapo,
idiopathic kapa congenital neutropenia ho batho ba baholo le bana,
phehella neutropenia ho bakuli ba nang Tšoaetso ea HIV (ka ho se sebetse hantle hoa mekhoa e meng ea kalafo).

Ketso ea pharmacological

Neupomax ke sefutho sa leukopoiesis. Neupomax e na le filgrastim, e leng ntho e etsang hore motho a boele a kopaneng le granulocyte colony factor (G-CSF). Ntho e sebetsang e na le ketsahalo e ts'oanang le G-CSF ea morao-rao; sebopeho sa lik'hemik'hale sa filgrastim se fapana le motsoako o mong oa masapo oa N-terminal eketsehileng methionine (filgrastim ke protheine e seng glycosylated). Karolo e sebetsang ea lithethefatsi e fumanoa ho sebelisoa theknoloji ea DNA e kopantsoeng le lisele tsa Escherichia coli, ka har'a lisebelisoa tsa lefutso tse hlahisoang ke mofuta oa mofuta oa liprotheine tsa G-CSF.

Neupomax e eketsa tlhahiso ea li-neutrophils ka ts'ebetso e khotsofatsang ea ts'ebetso, hammoho le ho kena ha bona betheng ea methapo ho tsoa lisele tsa moko oa masapo. Neupomax e sebetsa hantle ho neutropenia ea mefuta e fapaneng.

Pharmacodynamics ea lithethefatsi Neupomax

Tsamaiso ea methapo le e poteletseng ea filgrastim e lebisa ho tsepameng ho itšetlehileng ka maemo a eona a serum. Boholo ba phepelo ea filgrastim e fihla ho 150 ml / kg.

Nako e bolelang halofo ea bophelo ba filgrastim ke lihora tse 3,5, boemo bo tloaelehileng ba khaso ke 0,6 ml / min / kg.

Filgrastim ha e sebelisoe (ho bakuli ba fumaneng 'moko oa mothapo o ikemetseng, ea fumaneng filgrastim e tsoelang pele matsatsi a 28, ho ne ho se na matšoao a boloi ba lithethefatsi).

Mokhoa oa kopo

Neupomax e etselitsoe tsamaiso ea methapo ea bana kapa tsamaiso ea methapo. Tharollo e fanoa letsatsi le letsatsi ka mokhoa o ikhethileng kapa ka tsela ea infusions e khutšoane mothong (ho fihlela metsotso e 30). Haeba ho hlokahala, Neupomax e lumelloa ho tsamaisoa ka mokhoa oa infusion e tsoelang pele ea lihora tse 24. Mokhoa oa tsamaiso, hammoho le litekanyetso le nako ea tšebeliso ea Neupomax, li hlahisoa ke setsebi, li ela hloko matšoao le litšobotsi tsa hae tsa mokuli. Bakeng sa bakuli ba bangata, ho khethoa ka mokhoa o ikhethileng.

Ha e tsamaisoa ka mokhoa o sa ts'oaneng, ho kgothaletswa ho fetola sebaka sa ente sejoeng se seng le se seng (ho fetola libaka tsa ente ho fokotsa kotsi ea ho utloa bohloko kamora ho tsamaisoa ha moriana).

Tekanyetso ea Neupomax nakong ea cytotoxic chemotherapy

Ho li-regimens tse tloaelehileng tsa chemotherapy, 5 μg / kg ea boima ba mokuli hangata e beoa hanngoe ka letsatsi. Tekanyetso ena e fanoa letsatsi le letsatsi ka mokhoa o ikhethileng kapa ka methapo (ho fihlela metsotso e 30) ka ho lekola setšoantšo sa mali kamehla. Sesebelisoa se sebelisoa ho etsa hore palo ea neutrophil e se ke ea tšoana.

Ente ea pele ea filgrastim ha e etsoe pejana ho lihora tse 24 kamora ho phethoa ha chemotherapy. Nako ea ts'ebeliso ea filgrastim e fihla ho matsatsi a 14. Ha ho fanoa ka mofuta oa chemotherapy e sebelisitsoeng, kamora ho kopanya le ho phekola induction ea mofuta o matla oa leeloemia ea mokokotlo, nako ea ts'ebeliso ea tharollo ea Neupomax e ka eketseha ho fihlela matsatsi a 38. Ho bakuli ba bangata, keketseho ea nakoana ea palo ea li-neutrophils e tlalehiloe ka letsatsi la 2 - la 3 la kalafo ea filgrastim. Ha ho kgothaletswe ho tlohela kalafo ea filgrastim ho fihlela lipalo tse tloaelehileng tsa neutrophil li fumaneha kamora hore phokotso e kholo e reriloeng ea lipontšo tsena (ka ho khaotsa kalafo, monyetla oa ho fumana phello e tsitsitseng ea kalafo e fokotsehile). Phekolo ka Neupomax e felisoa haeba palo e felletseng ea li-neutrophils e eketseha ka holimo ho 10,000 / μl.

Tekanyetso ea Neupomax ho phekolo ea myeloablative ka ho fetisoa hape ha mongo

Tekanyetso ea ho qala ea filgrastim bakeng sa kalafo ea myeloablative e lateloang ke ho fetisoa (autologous kapa allogeneic) ea moko oa masapo ke 10 μg / kg ea boima ba mokuli. Lithethefatsi li fanoa kahare ho kenngoe kahare - (nako ea ho ts'oaroa ke metsotso e 30 kapa lihora tse 24). Hape hoa khoneha ho hlahisoa ha filgrastim ka ho kenella ka lihora tse 24.

Motsoako oa ho qala oa tharollo ea Neupomax ha o fanoe pele ho feta lihora tse 24 kamora ho phethoa ha cytotoxic chemotherapy mme ha ho sa feta nako ea lihora tse 24 kamora ho fetisoa ha masapo.

Nako ea ts'ebeliso ea tharollo ea Neupomax ho kalafo ea myeloablative ha e fetise matsatsi a 28. Tekanyetso ea letsatsi le letsatsi ea filgrastim e ka fetoloa ho nahanoa ka boemo ba neutrophils le matla a ho eketsa palo ea bona. Ha palo ea neutrophil e feta 1000 / μl ka matsatsi a mararo a latellanang, palo ea filgrastim e fokotsoa ho 5 μg / kg ea boima ba mokuli ka letsatsi. Haeba, kamora phetoho ea tekanyetso, boemo ba neutrophil bo feta 1000 / μl ka matsatsi a mararo a latellanang, tharollo ea Neupomax e hlakotsoe. Haeba, kamora ho fetola tekanyetso kapa ho hlakola tharollo ea Neupomax, palo ea li-neutrophils e fokotseha ho ea tlase ho 1000 / μl, o lokela ho khutlela tekong e fetileng ea filgrastim.

Tekanyetso ea Neupomax nakong ea ho khothaletsa lisele tsa mali tsa mali tse poteletseng ho bakuli ba nang le mafu a kotsi

Bakeng sa ho bokella lisele tsa mali a pheriterale, bakuli ba nang le mafu a tšoaetsanoang ba fuoe 10 μg / kg ea boima ba 'mele ka letsatsi subcutaneally bolus kapa infcutaneous infusion (bakeng sa lihora tse 24) matsatsi a 6 a latellanang. Khahlano le nalane ea ts'ebeliso ea filgrastim, 2 leukapheresis e etsoa ka tatellano (hangata ka letsatsi la 5 le la 6 la kalafo). Haeba ho hlokahala leukapheresis e eketsehileng, tsamaiso ea filgrastim e lokela ho tsoelapele ho fihlela ts'ebetso ea ho qetela e joalo.

Tekanyetso ea Neupomax kamora kalafo ea myelosuppress ho bokella lisele tsa mali tsa "peripheral"

Kamora ho etsa kalafo ea myelosuppress, hangata filgrastim e beoa ka tekanyo ea boima ba 5 μg / kg ea boima ba mokuli ka mokhoa oa ente ea leoto. Kalafo e nang le Neupomax e qala letsatsi kamora lethal dose la ho qetela la chemotherapy. Nako ea ts'ebeliso ea filgrastim e khethoa ke boemo ba li-neutrophils le matla a liphetoho lipalo tsa bona; ho khothalletsoa ho tsoela pele ho sebelisa boitokisetso ba Neupomax ho fihlela litekanyetso tse tloaelehileng tsa boemo ba neutrophil li fumanoe. Leukapheresis e etsoa kamora ho fihlela boemo ba neutrophil ba fetang 2000 / μl.

Tekanyetso ea Neupomax bakeng sa ho bokella lisele tsa mali tsa "peripheral" tsa mali ho bafani ba phetseng hantle molemong oa phetisetso ea allogeneic

Bafani ba phetseng hantle ba eletsoa ho tsamaisa filgrastim ka tekanyo ea boima ba 'mele ba 10 mcg / kg ka letsatsi. Nako ea thupelo ke matsatsi a 4-5, ao ka leukapheresis ka nako e 'ngoe u u lumellang ho fumana lisele tse 4 * 106 tsa CD34 + / kg tsa boima ba tsona. Ha ho na data mabapi le polokeho ea ho sebelisa filgrastim ho bafani ba phetseng hantle ba ka tlase ho lilemo tse 16 le lilemo tse fetang 60.

Tekanyetso ea lithethefatsi Neupomax a matla a sa foleng a neutropenia

Ka mofuta oa tlhaho oa neutropenia, filgrastim e beoa ka tekanyo ea 12 μg / kg ea boima ba mokuli ka letsatsi, ka idiopathic le nako le nako neutropenia, filgrastim e beoa ka tekanyo ea 5 μg / kg ea boima ba 'mele ka letsatsi. Maemong a joalo, Neupomax ea lithethefatsi e tsamaisoa ka mokhoa o sa ts'oaneng, tekanyetso ea letsatsi le letsatsi e ka aroloa ka liente tse 'maloa kapa ea fanoa ka nako e le' ngoe. Phekolo e lokela ho tsoelapele ho fihlela palo e tsitsitseng ea neutrophil ea ho feta 1500 / μl e fihlelloa. Kamora ho fumana palo e hlokahalang ea li-neutrophils, hoa hlokahala ho khetha tekanyetso e nyane ea filgrastim, e tla netefatsa hore palo ea li-neutrophils e bolokoa ka tekanyo e fanoeng.

Ha ho fanoa ka karabelo ea mokuli ho kalafo ea filgrastim, kamora libeke tse 1-2 tekanyetso e ka fokotsoa kapa ea eketsoa ka makhetlo a 2. Liphetoho tse ling tsa lethal dose li etsoa ka nako e le ngoe ho libeke tse 1-2. Tekanyetso e nepahetseng e nkoa e lumella boemo ba li-neutrophils hore bo lule bo bolokiloe kahare ho 1500-10000 / μl. Ho ts'oaetso e matla, keketseho e potlakileng ea lethal dose ea filgrastim e lumelloa.

Tšireletseho ea kalafo ea nako e telele e nang le filgrastim ka tekanyetso ea letsatsi le letsatsi ea feta 24 mcg / kg / ka letsatsi ho bakuli ba nang le mofuta o sa foleng oa neutropenia ha e so netefatsoe.

Tekanyetso ea Neupomax ea neutropenia ho bakuli ba nang le ts'oaetso ea HIV

Motsoako oa ho qala oa filgrastim ho bakuli ba nang le ts'oaetso ea HIV le neutropenia ke boima ba "1-4g / kg" ka boima ba mmele ka letsatsi. Tekanyetso e lokela ho kenngoa ho fumana boemo bo tloaelehileng ba li-neutrophils. Ho latela ts'ebetso ea mamello ea filgrastim le matla a ho eketseha ha palo ea li-neutrophils, tekanyo ea tharollo ea Neupomax e ka eketseha. Se ke oa sebelisa tse fetang 10 mcg / kg ea boima ba mokuli ka letsatsi.

Tekanyetso ea lithethefatsi Neupomax lihlopheng tse itseng tsa bakuli

Bakeng sa bana ba ka tlase ho lilemo tse 16, filgrastim e laetsoe litekanyetso tse khothalletsoang batho ba baholo. Palo ea tekanyetso ea filgrastim ho bana e lokela ho etsoa ho latela boima le matla a boemo ba li-neutrophils.

Bakuli ba tsofetseng ha ba hloke liphetoho tsa tekanyetso ea Neupomax.

Malebela mabapi le ho hlapoloha ha Neupomax

Ha e tsamaisoa ka mokhoa o ikhethileng, Neupomax ha e hlapolloe.

Bakeng sa ho hlophisoa ha tharollo ea infusion bakeng sa tsamaiso ea marotholi, ke tharollo ea 5% feela ea dextrose e lokelang ho sebelisoa. Ha hoa lumelloa ho sebelisa 0,9% sodium chloride (litharollo ha li lumellane).

Ho lokela ho hopoloa hore motsoako oa lithethefatsi Neupomax ka bongata ba 2-15 μg / ml o ka kenngoa ke lipolao le khalase. Ho thibela ho kenngoa ha filgrastim ka marako a vial, ho kgothaletsoa ho kenyelletsa serum albin ea motho tharollo (karolo ea ho qetela ea albin ho tharollo ea infusion e lokela ho ba 2 mg / ml). Haeba karolo ea ho qetela ea filgrastim e feta 15 μg / ml, ho kenyelletsoa ha albin ha ho hlokahale. Ho kenngoa ha moriana Neupomax oa litekanyetso ka tlase ho 2 μg / ml ho thibetsoe.

Litaelo tse khethehileng bakeng sa ts'ebeliso ea lithethefatsi Neupomax

Phekolo ea filgrastim e ka etsoa feela ke setsebi se nang le boiphihlelo se sebelisang lintlha tse tsosang takatso ea koloni, 'me se ipapisitse le matla a tlhahlobo ea tlhahlobo. Ho bokella lisele le apheresis ho lokela ho etsoa feela litsi tsa bongaka tse ikhethileng.

Bakuli ba nang le "neutropenia" e tebileng ba sa foleng ba lokela ho etsa lipatlisiso tsa tlhahlobo ea mafu ka mokhoa o hlakileng pele ba qala kalafo ea filgrastim ho khetholla li-pathologies tse ling tsa hematological (ho kenyelletsa le phofshoana e matla ea methapo, le myelodysplasia). Pele o qala kalafo, ho hlokahala hore ho etsoe tlhahlobo ea cytogenetic le morphological ea moko oa masapo.

Phekolo ea Neupomax e ka etsahala feela ka ho lekola khafetsa setšoantšo se akaretsang sa mali a potoloho ka lipalo tse tlamang tsa formula ea leukocyte le palo ea liplatelete (tlhahlobo ea pele e etsoa pele filgrastim e sebelisoa, ebe e phetoa bonyane makhetlo a 2 ka beke ka chemotherapy le bonyane makhetlo a 3 ka beke ka ho hlohlelletsa stem ea pherekano. lisele tsa mali). Haeba filgrastim e sebelisoa ho kopanya lisele tsa mali tsa mali, ka keketseho ea palo ea lisele tse tšoeu tsa mali tse fetang 100,000 / orl kapa ho fokotseha ha palo ea liplatelete tse ka tlase ho 100,000 / µl, Neupomax e lokela ho hlakoloa kapa hore tekanyo ea filgrastim e lokela ho fokotsoa. Ho tlameha ho hopoloa hore setlhare sa Neupomax ha se thibele ho ba teng ha phokolo ea mali le thrombocytopenia e amanang le chemotherapy ea myelosuppressive.

Ha ho na bopaki ba phello ea filgrastim ho graft khahlanong le karabelo e amohelang.

Hoa hlokahala hore u lule u lekola sephetho sa tlhahlobo ea moroto nakong ea phekolo le Neupomax (ho sa kenyele proteinuria le hematuria).

Ho khothalletsoa ho lekola boemo ba mokokotlo nakong ea phekolo le Neupomax.

Hoa hlokahala ho laola letsoalo le sebopeho sa lisele tsa masapo ho bakuli ba nang le methapo ea methapo kapa masapo nakong ea kalafo ea nako e telele le Neupomax.

Litlamorao

Khahlano le semelo sa kalafo ka moriana oa Neupomax ho bakuli, ponahalo ea karabelo e joalo e sa rateheng e ka etsahala:

Sistimi ea musculoskeletal: bohloko bo kopaneng, myalgia, bohloko ba masapo, osteoporosis.
Phekolo ea ka mpeng: hepatomegaly, mathata a ka setulong, ho ipolaisa tlala, ho hlatsa, ho nyekeloa le pelo.
Sistimi ea mali: leukocytosis, neutrophilia, thrombocytopenia, phokolo ea mali, ho hola le ho phatloha ha lesapo la mokokotlo.
Sistimi ea ho hlasimoloha: syndrome ea khatello ea matšoafo, infinrate.
CVS: khatello ea khatello ea mali, vasculitis.
Liphumano tsa laboratori: litekanyetso tse eketsehang (tse feto-fetohang) tsa uric acid, lactate dehydrogenase, gamma glutamyl transase le alkaline phosphatase ho serum, nakoana nakoana hypoglycemia (kamora ho ja).

Ntle le moo, nakong ea kalafo ka tharollo ea Neupomax, nts'etsopele ea proteinuria le hematuria, asthenia, ho eketseha ha mokhathala, petechiae, nosebleeds le erythema nodosum li tlalehiloe ho bakuli ba bang.

Ha u sebelisa lithethefatsi tsa Neupomax, bakuli ba ka ba le maikutlo a amanang le hypersensitivity ka mokhoa oa edema ea sefahleho, urticaria, ho hloleha ho phefumoloha, hypotension ea arterial le tachycardia.

Nts'etsopele ea foromo e matla ea myeloid leukemia le myelodysplastic syndrome ho bakuli ba nang le mofuta o phatlalalitsoeng oa neutropenia e sa foleng ba ile ba hlokomeloa. Khokahano e tobileng ea maloetse ana ka kalafo ea filgrastim ha e so ka e netefatsoa, leha ho le joalo, Neupomax e lokela ho fuoa bakuli ba nang le neutropenia e sa foleng feela ba nang le tlhaiso ea morphological le cytogenetic ea mokokotlo oa masapo (bonyane hang ka likhoeli tse 12). Ka nts'etsopele ea liphetoho tsa cytogenetic 'moko oa masapo, likotsi le melemo ea kalafo e tsoelang pele ka filgrastim e lokela ho hlahlojoa mme khetho ea ho khaotsa lithethefatsi tsa Neupomax e lokela ho tsotelloa.

Ntshetsopele ea leukemia le MDS e hloka ho felisoa ha Neupomax.

Neupomax ha e eketse khafetsa le ho teba ha liketsahalo tse bohloko tsa lithethefatsi tsa cytotoxic.

Filgrastim e ka lebisa keketseho e kholo palong ea lisele tse kulang, tse lokelang ho nahanoa nakong ea kalafo ea bakuli ba nang le lefu la lisele tse kulang.

Contraindication

Neupomax ha e fuoe bakuli ba nang le mamello ho likarolo tsa tharollo ea filgrastim kapa tse thusang.

Neupomax ha e sebelisoe kalafo ea bakuli ba nang le mathata a tebileng a congenital neutropenia (Costmann syndrome) le mathata a cytogenetic.

Neupomax e ke ke ea sebelisoa ho eketsa litekanyetso tsa lithethefatsi tsa chemotherapeutic cytotoxic ho feta tse khothalletsoang.

Ho hlokahala tlhokomeliso ha u sebelisa sethethefatsi sa Neupomax ho bakuli ba nang le mafu a kotsi le a sa foleng a mofuta oa myeloid (ho kenyelletsa le lefu la makhopho a hlobaetsang le mafua.

Ha ho na data mabapi le polokeho ea filgrastim ho bakuli ba nang le autoimmune neutropenia.

Boimana

Tšireletseho ea kalafo e nang le filgrastim ea basali baimana ha e ea thehoa. Hoa hlokahala ho etsa tlhahlobo e felletseng ea likotsi le melemo pele u fa Neupomax ho basali nakong ea kemolo.

Ha ho na data ho kenella ha Neupomax ka lebese la matsoele. Hoa hlokahala ho qeta ho anyesa pele u qala kalafo ka Neupomax.

Ho sebelisana le lithethefatsi

Tšireletseho ea ho sebelisa filgrastim ha e netefatsoe ho kopantsoe le lithethefatsi tsa myelosuppressive cytotoxic tse sebelisoang ho regimens ea chemotherapy (ha lithethefatsi tsena li fanoa ka letsatsi le le leng).

Ho na le bopaki ba keketseho ea ho teba ha neutropenia ha u ntse u sebelisa filgrastim le 5-fluorouracil.

Ts'ebeliso e kopaneng ea filgrastim le lintlha tse ling tsa kholo ea hematopoietic, hammoho le cytokines, ha e so ithutoe.

Ho khonahala ho eketsa ts'ebetso ea filgrastim ha e kopantsoe le litokisetso tsa lithium (litokisetso tsa lithium li susumetsa ho lokolloa ha li-neutrophils).

Tharollo ea Neupomax ha e lumellane le 0,9% sodium chloride.

Maemo a polokelo

Neupomax e lokela ho bolokoa e sa fihlelloe ke bana ka mocheso oa likhato tse 2-8 Celsius.

Ho thibetsoe ho theola tharollo.

Bophelo ba Shelf ke lilemo tse 2.

Kamora ho bula botlolo, tharollo e ke ke ea bolokoa.

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

Foromo ea boholo:

tharollo bakeng sa tsamaiso e kenang le e kenellang.

1 ml ea tharollo e na le:

ntho e sebetsang: filgrastim 300 mcg (likarolo tse limilione tse 30)

baamohelang: glacial acetic acid, sodium hydroxide (sodium hydroxide), sorbitol (sorbitol), polysorbate 80, metsi a ente.

Transparent kapa opalescent e nyane, e se nang mmala kapa e nang le mebala e nyane.

Melemo ea pharmacological

Pharadodynamics.

Motsoako o sebetsang oa lithethefatsi ke filgrastim - ntho e etsang hore motho a boele a kopane le granulocyte kolony (G-CSF). Filgrastim e na le ts'ebetso e ts'oanang ea tlhaho le G-CSF ea motho, 'me e fapana le ea morao-rao hobane ke protheine e seng ea glycosylated e setseng ea N-terminal methionine. Filgrastim e fumanoeng ke theknoloji ea DNA e kopantsoeng e arotsoe liseleng tsa bacterium Esherichiacoli, lisebelisoa tsa liphatsa tsa lefutso tse hlahisitseng gene e kenyang protheine ea G-CSF.

Filgrastim e tsosa sebopeho sa li-neutrophils tse sebetsang le ho tšolloa ha tsona maling ho tsoa mokokotlong oa lesapo; e sebelisoa kalafo ea bakuli ba nang le neutropenia ea methapo e fapaneng.

Mofumahali

Ka bobeli ka tsamaiso ea methapo le e poteletseng ea filgrastim, ho tsepamisa mohopolo ho hlakileng ha serum ho tse hlokoang lethalong ho bonoa. Bophahamo ba karolelano ea mali maling bo ka ba 150 ml / kg.

Bonyane halofo ea bophelo ba filgrastim e tsoang serum e ka ba lihora tse 3.5, 'me boemo ba clearance ke hoo e ka bang 0.6 ml / min / kg.

Ho kenella ha filgrastim ka nako e telele ho isa ho matsatsi a 28 ho bakuli kamora ho fetisoa ha lesapo la mokokotlo ha ho tsamaisane le matšoao a ho eketseha le ho eketseha ha halofo ea bophelo.

Litla-morao

Ho tsoa ts'ebetsong ea musculoskeletal: bohloko bo masapo, mesifa le manonyeletso, osteoporosis.

Ho tsoa ts'ebetsong ea tšilo ea lijo: ho ipolaisa tlala, lets'ollo, hepatomegaly, ho nyekeloa le pelo le ho hlatsa.

Litla-morao: lekhopho la letlalo, urticaria, ho ruruha sefahleho, ho sisinya, ho hema, ho fokotsa khatello ea mali, tachycardia.

Ho tsoa lithong tsa hemopoietic: neutrophilia le leukocytosis (ka lebaka la ts'ebetso ea pharmacological ea filgrastim), khaello ea mali, thrombocytopenia, ho hola le ho phatloha ha lesapo la mokokotlo.

Karolong ea mokhoa oa ho hema: lefu la khatello ea maikutlo la batho ba baholo, matšoafo le kenella.

Ho tsoa ho tsamaiso ea pelo le pelo: ho theola kapa ho eketsa khatello ea mali, vasculitis ea letlalo.

Ho tsoa matšoao a laboratori: keketseho e khutlelang ho dikahare tsa lactate dehydrogenase, alkaline phosphatase, gamma-glutamyltransferase, uric acid, hypoglycemia ea nakoana kamora ho ja, ka seoelo haholo: proteinuria, hematuria.

Tse ling: hlooho, mokhathala, bofokoli bo akaretsang, nosebleeds, petechiae, erythema nodosum.

Filgrastim ha e eketse menyetla ea karabelo e mpe ea cytotoxic kalafo.

Ho sebelisana le lithethefatsi tse ling

Tšireletseho le katleho ea tsamaiso ea li-filgrastim ka letsatsi le ts'oanang le lithethefatsi tsa myelosuppress antitumor ha li e-so thehoe.

Ho na le litlaleho tse arohaneng tsa ho teba ha neutropenia ha ho ntse ho khethoa ha filgrastim le 5-fluorouracil.

Hajoale ha ho na bopaki ba litšebelisano tse ka bang teng le lintlha tse ling tsa kholo ea hematopoietic le cytokines.

Lithium, e etsisang ho ntšoa ha li-neutrophils, e ka ntlafatsa phello ea filgrastim.

Ka meriana ha e lumellane le tharollo ea chloride ea 0,9%.

Litaelo tse khethehileng

Phekolo ea Neypomaksom e lokela ho etsoa feela ka tlasa taolo ea ngaka e nang le boiphihlelo ts'ebelisong ea lintlha tse susumetsang tsa koloni, ka bokhoni bo hlokahalang ba tlhahlobo ea mafu. Tsamaiso ea ho bokella lisele le mekhoa ea ho ruruha e lokela ho etsoa lihlopheng tse ikhethang tsa bongaka.

Tšireletseho le katleho ea li-filgrastim ho bakuli ba nang le myelodysplastic syndrome le leukemia e sa foleng ha li e-so thehoe, ka hona ha ho khothaletsoe ho sebelisa filgrastim bakeng sa maloetse ana. Ho lokela ho lebisoa tlhokomelo e khethehileng ho khethollo e khethollang lipakeng tsa leukemia e matla le lefu la ho phatloha hoa koluoa ea mokokotlo o sa feleng.

Pele ho khethoa ha Neupomax ho bakuli ba nang le 'mele o sa foleng oa neutropenia (TCH), tlhahlobo e khethollang e lokela ho etsoa ka hloko ho qhelela mafu a mang a hematological a joalo ka aplasiki anemia, myelodysplasia, le ts'oarelllo e sa feleng ea mokokotlo oa lesapo la mokokotlo le lokela ho etsoa pele ho kalafo.

Ka tšebeliso ea filgrastim ho bakuli ba nang le CTN, ho bile le maemo a ntlafatso ea lefu la myelodysplastic syndrome le myeleid leukemia e mpe haholo. Leha taba ea hore khokahano lipakeng tsa nts'etsopele ea maloetse ana le ts'ebeliso ea filgrastim ha e so theoe, sethethefatsi se lokela ho sebelisoa le TCH ka tlhokomeliso tlasa taolo ea morphological le cytogenetic analysis of marongo (nako e 1 ho likhoeli tse 12). Ha tlhekefetso ea cytogenetic e hlaha mokokotlong oa masapo, kotsi le melemo ea kalafo e eketsehileng ka filgrastim e lokela ho hlahlojoa ka hloko. Ka nts'etsopele ea MDS kapa leukemia, Neupomax e lokela ho emisoa.

Phekolo ea Neupomax e lokela ho etsoa kamora ho lekola khafetsa palo ea mali ka kakaretso ka palo ea leukocyte le palo ea liplatele (pele a qala kalafo mme ka makhetlo a 2 ka beke ka chemotherapy e tloaelehileng le bonyane makhetlo a 3 ka beke ka ho khothaletsa PSCC ka ho fetisoa kapa ka ntle ho tšohanyetso ea moko oa masapo). Ha o sebelisa Neupomax ho bokella PSCC, sethethefatsi sea hlakoloa haeba palo ea liteukocytes e feta 100,000 / μl. Ka palo e tsitsitseng ea liplatelete tse ka tlase ho 100,000 / μl, ho khothalletsoa ho tlohela nakoana kalafo ea filgrastim kapa ho fokotsa tekanyetso ea eona.

Filgrastim ha e thibele thrombocytopenia le phokolo ea mali ka lebaka la chemotherapy ea myelosuppressive.

Nakong ea kalafo ka Neupomax, urinalysis e lokela ho etsoa khafetsa (ho khetholla hematuria le proteinuria) 'me boholo ba mokokotlo bo lokela ho betoa leihlo.

Filgrastim e lokela ho sebelisoa ka hloko ho bakuli ba nang le lefu la lisele tse kulang mabapi le kholo ea kholo ea palo ea lisele tse kulang.

Tšireletseho le katleho ea lithethefatsi ho masea a sa tsoa hlaha le bakuli ba nang le autoimmune neutropenia ha li e-so thehoe.

Bakuli ba nang le methapo e kopaneng ea masapo le masapo a fumanang kalafo e tsoelang pele le Neupomax nako e fetang likhoeli tse 6 ba bontšoa taolo ea masapo a masapo.

Kameho ea filgrastim ho ts'ebetso ea graft khahlanong le moeti ha e e-so tsebisoe.

Fomu ea tokollo.

Tharollo bakeng sa tsamaiso e kenelletseng le e mahareng, 300 μg (likarolo tse limilione tse 30) ka 1 ml. Ho 1,0ml (300 mcg, diyuniti tse limilione tse 30) kapa 1.6 ml (480 mcg, diyuniti tse limilione tse 48) ka libotlolong tsa khalase, tse tiisitsoeng ka li thibela tse tsoang motsoakong oa rabara ka likhetla tsa aluminium.

Mabotlolo a 5, a pakiloeng ka har'a sephutheloana sa filimi ea PVC hammoho le litaelo tsa tšebeliso, a behiloe ka har'a pakete ea karete.

Mokhoa oa ho sebelisa: litekanyetso le kalafo

P / c kapa ka sebopeho sa infusions ea methapo e mokhuts'oane (nakong ea metsotso e 30), letsatsi le letsatsi ho fihlela palo ea li-neutrophils e fihla bonyane bo lebelletsoeng (nadir) ebe e khutlela mokheng o tloaelehileng. Setlhare se kenngoa ka tharollo ea 5% dextrose.

Mokhoa o lakatsehang oa tsamaiso ea moriana. Khetho ea tsela ea tsamaiso e latela boemo bo ikhethang ba kliniki.

Li-regimens tse tloaelehileng tsa cytotoxic: Li-unit tse 0,5 mil (5 mcg) / kg hang ka letsatsi. Tekanyetso ea pele ea lithethefatsi ha e fanoe pele ho feta lihora tse 24 ka mor'a cytotoxic chemotherapy. Nako ea kalafo e fihla ho matsatsi a 14. Kamora ho kenella le ho kopanya kalafo ea moriana o matla oa leukemia, nako ea kalafo e ka nyoloha ho fihlela matsatsi a 38, ho latela mofuta, lethal dose, le regten ea cytotoxic chemotherapy e sebelisitsoeng. Keketseho ea nakoana ea palo ea li-neutrophils hangata e bonoa matsatsi a 1-2 kamora ho qala kalafo. Ho fihlella phello e tsitsitseng ea kalafo, ho hlokahala hore u tsoele pele ho phekola ho fihlela palo ea li-neutrophils e feta ka tekanyo e lebelletsoeng ebe e fihlela litekanyetso tse tloaelehileng. Ha ho khothalletsoe ho hlakola lithethefatsi pele ho nako ho fihlela palo ea li-neutrophils e feta ka tekanyo e lebelletsoeng. Phekolo e emisoa haeba palo e felletseng ea li-neutrophils kamora hore nadir e fihle sekete se le seng / µl.

Kamora kalafo ea myelo-ablative, e lateloang ke ho fetisoa ka mokokotlo kapa allogeneic marow: ho kenngoa ka sc kapa iv (ka 20 ml ea tharollo ea 5% ea dextrose). Tekanyetso ea pele ke li-unit tse 1 tsa moriana (10 mcg) / kg ka letsatsi ho / Drip kapa bakeng sa metsotso e 30 kapa lihora tse 24 kapa ka ho kenella ka nako e telele bakeng sa lihora tse 24. kamora cytotoxic chemotherapy, le phetisetso ea masapo - ha ho sa feta lihora tse 24 kamora ho kenella ha masapo. Nako ea kalafo ha e fetise matsatsi a 28. Kamora ho fokotseha ho hoholo ha palo ea li-neutrophils (nadir), tekanyetso ea letsatsi le letsatsi e ntlafatsoa ho latela matla a palo ea li-neutrophils. Haeba palo ea li-neutrophils e feta 1 sekete / μl bakeng sa matsatsi a 3 a latellanang, litekanyetso li fokotsoa ho li-unit tse 0,5 / kg / ka letsatsi, joale haeba palo e felletseng ea li-neutrophils e feta 1 sekete / μl ka matsatsi a 3 a latellanang, lithethefatsi li hlakotsoe. Haeba nakong ea kalafo palo e felletseng ea li-neutrophils e fokotseha ka tlase ho sekete / thel, lethalinyana le boetse le eketseha ho latela morero oo u o filoeng.

Ho khothaletsoa ha lisele tsa methapo ea mali tsa pheriferale (PSCC) kamora kalafo ea myelosuppressive e lateloang ke ho fetisoa ka mokhoa o ikemetseng oa PSCC ka phetisetso ea 'moko kapa ntle le masapo kapa ho bakuli ba nang le kalafo ea myeloablative e lateloang ke tšelo ea PSCC: li-unit tse milone (10 mcg) / kg ka letsatsi ka ho tsoelapele. Ho kenella ka nako ea lihora tse 24 / s kapa c / 1 sindelo ka nako e le 'ngoe ka matsatsi a 6 a latellanang. Ho khothalletsoa ho etsa leukapheresis tse 3 ka tatellano ka la 5, 6 le la 7 matsatsi.

Ho hlohlelletsoa ha PSCA kamora mamello ea myelosuppress: yuniti tse limilione tse 0.5 (5 μg) / kg ka letsatsi ka ente ea letsatsi le letsatsi, ho qala ka letsatsi la 1 kamora hore chemotherapy e phetheloe ho fihlela palo ea li-neutrophils e feta bonyane bo lebelletsoeng ebe e fihla ho tloaelehileng boleng. Leukapheresis e lokela ho etsoa nakong ea ha palo e felletseng ea li-neutrophils e nyoloha ho tloha tlase ho 500 ho isa ho 5,000 / μl. Bakeng sa bakuli ba sa fumaneng chemotreapia, seboka se le seng sa leukapheresis se lekane. Maemong a mang, ho khothalletsoa ho etsa lithuto tse ling tsa leukapheresis.

Ho khothaletsoa ha PSCC ho bafani ba phetseng hantle bakeng sa phetisetso ea allogeneic: s / c 1 unit unit (10 μg) / kg / letsatsi bakeng sa matsatsi a 4-5 e fana ka palo ea CD34 + limilione tse 4 / kg.

Matla a sa feleng a neutropenia: letsatsi le leng le le leng, hanngoe kapa ka makhetlo a 'maloa ente ea lithethefatsi. Ka congenital neutropenia, tekanyetso ea pele ke li-unit tse limilione tse 1,2 (12 μg) / kg / letsatsi, ka idiopathic kapa nako le nako neutropenia - likarolo tse limilione tse 0.5 (5 μg) / kg / letsatsi ho fihlela keketseho e tsitsitseng ea palo ea li-neutrophils e feta 1500 / μl. Kamora hore phello ea kalafo e fihlelloe, tekanyetso e sebetsang e tlase e ikemiselitsoe ho boloka boemo bona, mme tsamaiso ea letsatsi le letsatsi ea nako e telele ea hlokahala. Kamora libeke tse 1-2 tsa kalafo, tekanyetso ea pele e ka imena habeli kapa ea fokotsoa ke 50%, ho latela karabelo ea mokuli kalafong. Kamora moo, libeke tse ling le tse ling tse 1-2, o ka etsa phetoho ea tekanyetso ea motho ka mong ho boloka palo ea li-neutrophils tse fapaneng ea 1.5-10 likete / μl. Molemong oa tšoaetso e matla, regimen e nang le keketseho e potlakileng ea tekanyetso e ka sebelisoa. Ho 97% ea bakuli ba arabileng hantle kalafong, kalafo e felletseng e ile ea bonoa le litekanyetso ho fihlela ho 24 mcg / kg / ka letsatsi. Tekanyetso ea letsatsi le letsatsi ha ea lokela ho feta 24 mcg / kg / letsatsi.

Neutropenia ts'oaetso ea HIV: lethal dose ea mantlha ke li-unit tse 0,1,0,4 limilione tse (1-4 μg) / kg / letsatsi hang, s / c ho etsa hore palo ea li-neutrophils e thathamisehe. Tekanyo e phahameng ea letsatsi le letsatsi ke 10 mcg / kg. Normalization ea palo ea li-neutrophils hangata e hlaha kamora matsatsi a mabeli. Kamora ho fumana phello ea kalafo, tekanyetso ea tlhokomelo ke 300 mcg / letsatsi makhetlo a 2-3 ka beke ho latela morero oa alternating. Kamora nako, tokiso ea tekanyetso ea motho ka mong le taolo ea nako e telele ea lithethefatsi e ka hlokoa ho boloka palo ea li-neutrophils tsa batho ba fetang likete tse 2 / μl.

Bakeng sa bakuli ba tsofetseng, tokiso ea tekanyetso ha e hlokehe.

Litlhahiso mabapi le litekanyetso tsa lithethefatsi ho bana li tšoana le ho batho ba baholo ba fumanang myelosuppressive chemotherapy.

Haeba moriana o kentsoe lethathamong la litheko tse ka tlase ho limilione tse 1.5 (15 μg) / ml, serum albin ea motho e lokela ho eketsoa tharollo e le hore khatello ea ho qetela ea albin e be 2 mg / ml (mohlala, ka boholo ba tharollo ea 20 ml, tekanyetso e felletseng ea lithethefatsi e ka tlase ho limilione tse 30 ED (300 μg) e lokela ho tsamaisoa ka 0,5 ml ea tharollo ea 20% ea albin ea motho). U ke ke ua hlapollela lithethefatsi kamora ea ho qetela ea li-unit tse ka tlase ho limilione tse 0,2 (2 μg) / ml.

Neupomax, litaelo tsa tšebeliso (Mokhoa le litekanyetso)

Maemong a mangata, lithethefatsi li tsamaisoa letsatsi le leng le le leng ka tsela e fapaneng, maemong a mang - infusion (qhala feela ka tharollo ea 5% dextrose) Khetho ea tsela ea tsamaiso le litekanyetso tsa Neupomax ho latela boemo ba bongaka. Mokhoa oa kalafo o rarahane haholo, o fapana ka mafu le maemo a fapaneng. Mona ke tse ling tsa tsona.

Kamora thupelo chemotherapy beoa 5 mcg / kg hang ka letsatsi s / c letsatsi le letsatsi ho fihlela tloaelehileng neutrophils. Tekanyetso ea pele e fanoa ka letsatsi le le leng kamora ho fela chemotherapy. Nako ea kalafo e fihlile ho libeke tse peli. Kamora pheko ea induction a hlobaetsang myeloid leukemia Nako ea kalafo e ka ba matsatsi a 38. Keketseho ea palo neutrophils Ho tsebahala kamora matsatsi a 1-2, leha ho le joalo, ho fihlela sephetho se tsitsitseng, kalafo ha ea lokela ho sitisoa.

Phekolo ea Myeloablative pele ho fetisoa mongobo

Phekolo e qala ka 10 mcg / kg ka letsatsi, e tsamaisoang kahare. Nako ea kalafo e fihlile ho matsatsi a 28.

Ho susumetsa CPMC bafani - 10 mcg / kg nako e le 1 ka letsatsi, ka mokhoa o ikhethileng ho fihlela matsatsi a 5 ka tsamaiso e eketsehileng leukapheresis.

Ho susumetsa CPMC ho bakuli ba tšoaroang chemotherapy - 5 mcg / kg hang ka letsatsi, ka mokhoa o ikhethileng, letsatsi le letsatsi ho fihlela maemong a tloaelehileng neutrophils. Leukapheresis e etsoa ha li-neutrophils li fihlela boleng> 2000 / μl.

Neutropenia ho bakuli ba nang Tšoaetso ea HIV - 1-4 mcg / kg nako e le 1 ka letsatsi, ka mokhoa o ikhethileng ho fetola boleng neutrophils. Ebe u sebelisa tekanyetso ea tlhokomelo - 3 mcg / kg ka letsatsi le leng le le leng.

Mofumahali

Ka "in '/ in and s / ho kenyelletsa Neupomax, ho tsepamisitsoe mohopolo o hlakileng oa serum molemong oa filgrastim ho lethal dose.

Bophahamo ba khaso e siea hoo e ka bang 150 ml / kg. Tlhahiso e tlase ke hoo e ka bang 0.6 ml / min / kg.

Nako ea bophelo ba serum ke hoo e ka bang lihora tse 3.5.

Ka ts'ebetso e sa khaotseng ea Neupomax ka nako e fetang matsatsi a 28, bakuli ba ts'elisang 'moko oa marapo oa mokokotlo ha ba ka ba le keketseho ea halofo ea bophelo le ho eketseha ha ntho e sebetsang.

Litaelo bakeng sa ts'ebeliso ea Neupomax: mokhoa le litekanyetso

Neupomax e tsamaisoa ka sc ka mokhoa oa liente kapa iv ka tsela ea infusions e khutsitseng ea metsotso e 30. Hape, haeba ho hlokahala, tsamaiso ea sc kapa intravenous e khonahala ka tsela ea infusions ea lihora tse 24. Ngaka e khetha tsela e nepahetseng ea ho tsamaisa ho latela boemo bo ikhethang ba mokuli, empa tsela e tsamaeang hantle ea ts'ebetso ea lithethefatsi e nkoa e le eona e loketseng haholo.

Letsatsi le letsatsi, sebaka sa ente se khothalletsoa ho fetoloa, sena se tla qoba bohloko nakong ea ho hlahisa tharollo.

Melao ea ho hlophisa tharollo:

Ka tsamaiso ea subcutaneous, Neupomax ha e fuoe. Haeba ho hlokahala, kenella e le soso u sebelisa tharollo ea dextrose 5%.
Ka lebaka la ho se lumellane ha litlhare, ha hoa lumelloa ho sebelisa tharollo ea sodium chloride ea 0,9%.
Neupomax e halikiloeng ka likhakanyo tsa 2-5 μg / ml e ka bapatsoa ka polasetiki le khalase. Ho thibela ho amoheloa ke bana, ho hlokahala hore ho eketsoe serum albin ea motho tharollong, tekanyetso ea eona e baloa e le hore mahloriso ho tharollo ea ho qetela ke 2 mg / ml
Albumin ha ea lokela ho kenyelletsoa ho Neupomax e hlapolotsoeng ka mohoanto ka holimo ho 15 μg / ml.
Neupomax e kenelletsoeng ka har'a likhakanyo tse ka tlase ho 2 μg / ml ha ea lokela ho sebelisoa.

Schemes e tloaelehileng ea Cytotoxic Chemotherapy

Motsoako o khothalelitsoeng ke 5 mg ka kilo ea boima ba 'mele hang ka letsatsi sc kapa iv ka sebopeho se sekhuts'oanyane sa metsotso e 30.

Motsoako oa pele ha oa fanoa pele ho feta lihora tse 24 kamora ho fela ha cytotoxic chemotherapy.

Neupomax e sebelisoa letsatsi le letsatsi ho fihlela, kamora ho fokotseha ho hoholo hoa maemo a li-neutrophils, palo ea bona e khutlisetsoa ho tloaelehileng, empa eseng ho feta matsatsi a 14. Kamora ho fihlela ho tloaelehileng, Neupomax e hlakotsoe.

Nako ea kalafo e ka eketsoa ho isa ho matsatsi a 38 ho bakuli ba fumanang kalafo ea ho kopanya le ea induction mabapi le leukemia e matla ea morao. Maemong ana, nahana ka mofuta oa mofuta oa mofuta oa chemotherapy, mofuta oa ona le tekanyetso.

Keketseho ea nakoana ea palo ea li-neutrophils hangata e bonoa ka matsatsi a 1-2 kamora ho qala ts'ebeliso ea filgrastim. Bakeng sa ho fihlela phello e tsitsitseng ea kalafo, kalafo ha ea lokela ho kena-kenana ho fihlela litekanyetso tse tloaelehileng tsa neutrophil li fihlella kamora ho fokotseha ho hoholo ha palo ea bona. Ketsahalong eo palo e felletseng ea li-neutrophils e fetang 10,000 / μl, Neupomax e hlakotsoe.

Ho sa foleng ha neutropenia (TCH)

Motsoako oa pele oa letsatsi le letsatsi ke: ka congenital neutropenia - 12 mcg / kg, e nang le idiopathic kapa neutropenia ea nako le nako - 5 mcg / kg. Setlhare sena se tsamaisoa ka s / c hang kapa ka matsatsi a 'maloa, ho fihlela palo ea li-neutrophils e tsitsitse kaholimo ho 1500 / μl. Kamora ho fihlella phello e hlokahalang bakeng sa poloko ea eona, Neupomax e sebelisoa ka tekanyetso ea tlhokomelo e ikemiselitsoeng ka bonngoe. Kamora libeke tse 1-2 tsa kalafo, ho latela karabelo ea mokuli, tekanyetso ea pele e imena habeli kapa ea emisoa.

Nakong e tlang, hang ka mor'a libeke tse ling le tse ling tse peli, haeba ho hlokahala, ho etsoa phetoho ea tekanyetso e le hore e u lumelle ho boloka palo ea li-neutrophils tse pakeng tsa 1500 / μl ho isa 10,000 / μl.

Bakuli ba nang le ts'oaetso e matla ba ka phekoloa ho latela mofuta oa tlhahiso e khothalletsang keketseho e potlakileng ea tekanyetso.

Tšireletseho ea tšebeliso ea nako e telele ea filgrastim litekanyetso tsa letsatsi le letsatsi tsa bakuli ba fetang 24 24gg / kg ha e so theoe.

Phekolo ea Myeloablative e lateloang ke ho fetisoa ha motsoako oa mokokotlo kapa allogeneic

Phekolo e qala ka tekanyetso ea letsatsi le letsatsi ea 10 mcg / kg. Neupomax e tsamaisoa kahare ka mokhoa oa infusion e khutšoane ea metsotso e 30, infravenous ea infravenous kapa subcutaneous infusion.

Tekanyetso ea pele e ka fanoa pele ho feta lihora tse 24 kamora ho fela ha thupelo ea cytotoxic chemotherapy, haeba ts'oaetso ea marapo e ka ba teng - pele ho feta lihora tse 24. Nako ea ts'ebeliso ea Neupomax ha ea lokela ho feta matsatsi a 28.

Tekanyetso ea letsatsi le letsatsi e ka fetoloa ho latela palo ea hona joale ea li-neutrophils. Haeba ka matsatsi a mararo a latellanang palo e felletseng ea li-neutrophils e feta 1000 / μl, tekanyetso ea letsatsi le letsatsi e fokotseha ho 5 μg / kg, ha matsatsing a 3 a latelang ha u sebelisa Neupomax ka tekanyetso ena palo e felletseng ea li-neutrophils ha e theohe ka tlase ho 1000 / μl, lithethefatsi li hlakotsoe. Haeba ho na le phokotseho ea palo ea li-neutrophils tse ka tlase ho 1000 / μl, joale lethal e boetse le nyolleloa ho ea mantlha.

Ho khothaletsoa ha Lisele tsa Mali a Tsamaeang ka Mali ho Rona (PSCC) ho Bakuli ba nang le mafu a Tumor

Motsoako o khothalelitsoeng ke 10 mcg / kg hang ka letsatsi sc e le ente kapa infusion e tsoelang pele ea lihora tse 24. Setlhare sena se sebelisoa letsatsi le letsatsi bakeng sa matsatsi a 6. Ho feta moo, ka letsatsi la bohlano le la botšelela, leukapheresis hangata e bakoa. Haeba ho hlahisoa leukapheresis e eketsehileng kapa e eketsehileng, kenyelletso ea Neupomax e tsoela pele ho fihlela qetellong ea ts'ebetso ea ho qetela.

Ho khothaletsoa haCCCC kamora chemelosuppressive chemotherapy

Neupomax e tsamaisoa ka sc ka mokhoa oa liente tsa letsatsi le letsatsi.

Tekanyetso ea letsatsi le letsatsi e khothalletsoang ke 5 mcg / kg. Pilisi ea pele e fanoa ka mor'a kamora ho fela ha chemotherapy, kalafo e ntse e tsoela pele ho fihlela palo e tloaelehileng ea neutrophil e fihla.

Leukapheresis e ka etsahala feela kamora palo ea li-neutrophils e fetang letšoao la 2000 / μl.

HIV Neutropenia

Setlhare se fanoa ka sc. Phekolo e qala ka tekanyetso ea letsatsi le letsatsi ea 1-4 μg / kg mme e tsoela pele ho fihlela palo ea neutrophils e lekantsoe. Maemong a mang, hoa khoneha ho eketsa tekanyetso ea letsatsi le letsatsi, empa eseng ho feta 10 μg / kg.

Kamora ho fumana phello ea kalafo, tekanyetso ea Neupomax e fokotseha ho tekanyetso ea tlhokomelo, eo hangata e leng 300 mcg letsatsi le leng le le leng.

Nakong e tlang, ngaka e fetola moriana oa dosing ka bonngoe ho mokuli e mong le e mong e le hore tekanyetso e boloka palo e tloaelehileng ea li-neutrophils tse kaholimo ho 2000 / μl.

Bokhachane le pelehi

Tšireletseho ea filgrastim nakong ea ts'ebeliso ea eona nakong ea bokhachane ha e e-so thehisoe, ka hona, moriana o ka fuoa feela haeba phaello e lebelletsoeng e hlile e phahame ho feta likotsi tse ka bang teng.

Bokhoni ba filgrastim ho kenella ka lebeseng la matsoele ha e so theoe, ka hona, nakong ea lebone, ha ho khothaletsoe ho khethoa ha Neupomax

Tlhahlobo mabapi le li-Neypomaks

Ho latela litlhahlobo tsa Neupomax, lithethefatsi ha li fuoe feela neutropenia e amanang le chemotherapy, empa le phokotseho e kholo ea palo ea li-neutrophils maling ka lebaka la mafu a mang a mangata a autoimmune le oncological. Hape, ts'ebeliso ea filgrastim e bohlokoa bakeng sa ts'oaetso ea HIV le vaerase hepatitis C ho bakuli ba fumanang kalafo ea antiviral, e nang le ramatiki ea bana.

Ho sa tsotelehe pontšo, ha ho sebelisoa Neupomax, keketseho e potlakileng ea palo ea li-neutrophils le leukocytes e ile ea hlokomeloa, karabelo ea ts'usumetso e etsahetse kamora matsatsi a ka bang 9. Leha ho le joalo, bakuli ba fumanang lithethefatsi tse thibelang likokoana-hloko, filgrastim e lokela ho sebelisoa nako e telele.

Ho na le litletlebo tse arohaneng mabapi le nts'etsopele ea litla-morao, tse kang ho chaba, bohloko bo kopaneng le ba masapo, feberu, molomo o omileng le hlooho.

Kahoo, Neupomax e sebelisoa khafetsa mme e sebetsa hantle haholo kalafong le thibelong ea neutropenia.