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NEUPOGEN Filgrastim ; Product Site sponsored by Amgen Inc. ; PDQ-NCI's Comprehensive Cancer Database.
Number of molecular mechanisms. Even though studies to investigate the effect of GCs on bone cells have been carried out in the last several decades, its effect on intestinal calcium transport and renal calcium elimination are not clear. In humans and rats, intestinal calcium absorption decreases in the presence of long-term and high doses of GCs 34 ; . Decrease in active transcellular transport and in normal brush-border vesicle uptake of calcium, and reduced calcium-binding proteins in the intestine, are considered cellular mechanisms resulting in diminished intestinal calcium absorption 18, 26, 49 ; . In parallel, it has been widely accepted that GCs increase renal calcium elimination and it increased the epithelial calcium transporters and calbindin-D28k 39 ; . Long-term treatment with GCs.
Et al. Spontaneous splenic rupture following administration of granulocyte colony-stimulating factor G-CSF ; : occurrence in an allogeneic donor of peripheral blood stem cells. Biol Blood Marrow Transplant. 1997; 3: 45-9 . 6. C. Kasper, L. Jones, Y. Fujita, G.R. Morgenstern, J.H. Scarffe, J. Chang. Splenic rupture in a patient with acute myeloid leukemia undergoing peripheral blood stem cell transplantation. Ann Hematol 1999; 78: 91-2. Franca Falzetti, Franco Aversa, Olivia Minelli, Antonio Tabilio. Spontaneous rupture of spleen during peripheral blood stemcell mobilization in a healthy donor. Lancet. Feruary 1999; 353: 555. Pitini V, Ciccolo A. Arrigo C, Aloi G, Micali C, La Torre F. Spontaneous rupture of spleen during peripheral stem-cell mobilization in a patient with breast cancer. Haematologica 2000; 85: 559-60. Dennis P O`Malley, Mark Whallen, Peter M. Banks. Spontaneous splenic rupture with fatal outcome following GCSF administration for myelodysplastic syndrome. American Journal of Hematology 2003; 73: 294-8. Humbelina Balaguer, Antoni Galmes, Gabriel Ventayol, Joan Bargay, Joan Besalduch. Splenic rupture after granulocyte colony-stimulating factor mobilization in a peripheral blood progenitor cell donor. Transfusion 2004; 44: 1260-1. Dincer AP, Gottschall J, Margolis DA. Splenic rupture in a parental donor undergoing peripheral blood progenitor cell mobilization. J Pediatr Hematol Oncol 2004; 26: 761-3. Martinez C, Urbano-Ispizua A, Marin P, Merino A, Rovira M, Carreras E, et al. Efficacy and toxicity of high-dose G-CSF schedule for peripheral blood progenitor cell mobilization in healthy donors. Bone Marrow Transplant 1999; 24: 1273-8. Monika Engelhardt, Hartmut Bertz, Matthias Afting, Cornelius F. Waller, Jurgen Finke. High- versus standard-dose filgrastim rhG-CSF ; for mobilization of peripheral-blood progenitor cells from allogeneic donors and CD34 + immunoselection. J Clin Oncol 1999; 17: 2160-72 . 14. Kroger N, Zeller W, Fehse N, Hassan T, Kruger W, Gutensohn K, et al. Mobilizing peripheral blood stem cells with high-dose G-CSF alone is as effective as with Dexa-BEAM plus G-CSF in lymphoma patients. British Journal of Haematology 1998; 102: 1101-06. Gazitt Y, Freytes CO, Callender N, Tsai TW, Alsina M, Anderson J, et al. Successful PBSC mobilization with highdose G-CSF for patients failing a first round of mobilization. J Hematother 1999; 8: 173-83 . 16: Paolo De Fabritiis, Anna Paolo Iori, Andrea Mengarelli, Maria Gozzer, Giancarlo Ferrazza, Maria Stefania De Propris, et al. CD34 + cell mobilization for allogeneic progenitor cell transplantation: efficacy of short course of G-CSF. Transfusion 2001; 41: 190-195 Andrew P. Grigg, Andrew W. Roberts, Heike Raunow, Sue Houghton. Judith E. Layton, Andrew W. Boyol, et al. Optimizing dose and scheduling of filgrastim Granulocyte Colony-Stimulating Factor ; for mobilization and collection of peripheral blodd progenitor cells in normal volunteers. Blood 1995; 86: 4437-45. Link H, Arseniev L, Bahre O, Berenson RJ, Battmer K, Kadar JG, et al. Combined transplantation of allogeneic bone marrow and CD34 + blood cells. Blood 1995; 86: 2500-8. David Stroncek, Thomas Shawker, Dean Follmann, Susan F. Leitman. G-CSF-induced spleen size changes in peripheral blood progenitor cell donors. Transfusion Vol 43, May 2003; 609-13. 20. Marco Picardi, Gennardo De Rosa, Carmine Selleri, Nicola Scarpato, Ernesto Soscia, Vincenzo Martinelli, et al. Spleen enlargement following recombinant human granulocyte colony-stimulating factor administration for peripheral blood stem cell mobilization. Haematologica 2003; 88: 794-800.
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One of the most challenging problems for pharmaceutical policy is how to pay for very expensive new drugs for rare diseases, sometimes known as "orphan drugs". There has been an increase in the number of such drugs over the last few years, as well as in the level of expense for certain drugs. At the top end, Genzyme is marketing some drugs with annual costs of over 0, 000 per patient. Given the increasing personalization of medicine, it is likely that the number of very expensive drugs for relatively rare conditions may increase substantially in the near future Haffner, Whitley, and Moses, 2002 ; . The provincial insurance plans like other insurers worldwide ; therefore need a way of deciding whether, and how much, to pay for such drugs. This paper argues that it is possible, and necessary, to develop a coherent rule concerning coverage for very expensive drugs. The rule has to balance two conflicting goals: having strong incentives to develop new therapies, and being able to afford those therapies without bankrupting drug insurance plans. Nearly 7, 000 rare diseases and conditions have been identified, with hundreds of new pathologies described globally every year, most of which.
This work was supported by the Deutsche Forschungsgemeinschaft postdoctoral fellowship to F.J. ; and by U.S. Public Health Service Grants GM31001 to E.F.J. ; and GM49511 to J.L.R. ; . 1 Abbreviations used are: P450, cytochrome P450; CYP, cytochrome P450; PCR, polymerase chain reaction; DLPC, dilauroyl-L lecithin; IgG, immunoglobulin. Send reprint requests to: Dr. Eric F. Johnson, The Scripps Research Institute, Division of Biochemistry NX 4, 10550 North Torrey Pines Road, La Jolla, CA 92037.
Eds. Asthma. London: Chapman and Hall, 1983; 242-84 Cookson JB. Prevalence rates of asthma in developing countries and their comparison with those in Europe and North America. Chest 1987; 91: 97 Wilson-Pessano SR, McNabb WL. The role of patient education in the management of childhood asthma. Prey Med 1985; 14: 670-87 Gergen PJ, Weiss KB. Changing patterns of asthma hospitalization among children: 1979 to 1987. JAMA 1990; 264: 1688-92 Wissow LS, Gittelsohn AM, Szklo M, et al. Poverty, race, and hospitalization for childhood asthma. J Public Health 1988 and flax.
Purpose: The purpose of this study was to compare the effects of filgrastim, sargramostim, or sequential sargramostim and filgrastim on CD34 cell yields and morbidity after myelosuppressive mobilization chemotherapy MC ; . Patients and Methods: One hundred fifty-six patients were randomized to receive filgrastim n 51 ; , sargramostim n 52 ; , or sargramostim for 5 days followed by filgrastim n 53 ; after MC with either cyclophosphamide and etoposide n 75 ; or paclitaxel and cyclophosphamide n 81 ; . Results: Compared with those who received sargramostim, patients who received filgrastim had faster recovery of an absolute neutrophil count of 0.5 109 L or greater a median of 11 v days; P .0001 ; , with fewer patients requiring RBC transfusions P .008 ; , fewer patients with fever 18% v 52%; P 0.001 ; , fewer hospital admissions 20% v 42%; P .013 ; , and less intravenous antibiotic therapy 24% v 69%; P .001 ; . Patients who received filgrastim yielded more CD34 cells median, 7.1 v 2.0 106 kg apheresis; P.
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Cycle repeats: Every 21 days. Variations 1. Bui, et al administered mesna 3, 000 mg m2 day CIVI days 1, 2, 3; doxorubicin 20 mg m2 day CIVI days 1, 2, 3; ifosfamide 2, 500 mg m2 IV over 3 hours days 1, 2, 3; dacarbazine 300 mg m2 IV over 1 hour days 1, 2, 3; and lenograstim 5 mcg kg day subcutaneous days 4 to 13, or days 4 to 16 ANC less than 1, 000 cells mcL on day 13.7 2. Kraybill, et al administered mesna 2, 500 mg m2 day CIVI days 1, 2, 3; doxorubicin 20 mg m2 day CIVI days 1, 2, 3; ifosfamide 2, 500 mg m2 day CIVI days 1, 2, 3; dacarbazine 225 mg m2 day CIVI days 1, 2, 3; and filgrastim 5 mcg kg day subcutaneous starting on day 5 and continuing daily until absolute granulocyte count greater than 1, 500 cells mcL.3.
Continuous cytokine support with filgrastim and epoetin alpha was also started; no platelet transfusions have been required and flexeril.
REFERENCES 1. Browman GP, Levine MN, Mohide EA, Hayward RSA, Pritchard KI, Gafni A, et al. The practice guidelines development cycle: A conceptual tool for practice guidelines development and implementation. J Clin Oncol 1995; 13: 502-12. Rusthoven J, Bramwell V, Stephenson B and the Provincial Systemic Treatment Disease Site Group. Use of granulocyte colony-stimulating factor G-CSF ; in patients receiving myelosuppressive chemotherapy for the treatment of cancer. Cancer Prev Control 1998; 2: 179-90. Crawford J, Ozer H, Stoller R, Johnson D, Lyman G, Tabbara I, et al. Reduction by granulocyte colony-stimulating factor of fever and neutropenia induced by chemotherapy in patients with smallcell lung cancer. N Eng J Med 1991; 325: 164-70. Pettengell R, Gurney H, Radford JA, Deakin DP, James R, Wilkinson PM, et al. Granulocyte colony-stimulating factor to prevent dose-limiting neutropenia in Non-Hodgkin's Lymphoma: a randomized controlled trial. Blood 1992; 80: 1430-6. Trillet-Lenoir V, Green J, Manegold C, Von Pawel J, Gatzemeier U, Lebeau B, et al. Recombinant granulocyte colony stimulating factor reduces the infectious complications of cytotoxic chemotherapy. Eur J Cancer 1993; 29A: 319-24. Nguyen Bui B, Chevallier B, Chevreau C, Krakowski I, Peny A-M, Thyss A, et al. Efficacy of lenograstim on hematologic tolerance to MAID chemotherapy in patients with advanced soft tissue sarcoma and consequences on treatment dose-intensity. J Clin Oncol 1995; 13: 2629-36. Chevallier B, Chollet P, Merrouche Y, Roche H, Fumoleau P, Kerbrat P, et al. Lenograstim prevents morbidity from intensive induction chemotherapy in the treatment of inflammatory breast cancer. J Clin Oncol 1995; 13: 1564-71. Woll PJ, Hodgetts J, Lomax L, Bildet F, Cour-Chabernaud V, Thatcher N. Can cytotoxic doseintensity be increased by using granulocyte colony-stimulating factor? A randomized controlled trial of Lenograstim in small-cell lung cancer. J Clin Oncol 1995; 13: 652-9. Jones SE, Schottstaedt MW, Duncan LA, Kirby RL, Good RH, Menel RG, et al. Randomized double-blind prospective trials to evaluate the effects of sargramostim versus placebo in a moderate-dose fluorouracil, doxorubicin, and cyclophosphamide adjuvant chemotherapy program for stage II and III breast cancer. J Clin Oncol 1996; 14: 2976-83. Muhonen T, Jantunen I, Pertovaara H, Voutilainen L, Maiche A, Blomqvist C, et al. Prophylactic filgrastim G-CSF ; during mitomycin-C, mitoxantrone, and methotrexate MMM ; treatment for metastatic breast cancer. J Clin Oncol 1996; 19: 232-4. Fridrik MA, Greil R, Hausmaninger H, Krieger O, Oppitz P, Stger M, et al. Randomized open label phase III trial of CEOP IMVP-Dexa alternating chemotherapy and filgrastim versus CEOP IMVP-Dexa alternating chemotherapy for aggressive non-Hodgkin's lymphoma NHL ; . A multicenter trial by the Austria Working Group for Medical Tumor Therapy. Ann Hematol 1997; 75: 135-40. Gisselbrecht C, Haioun C, Lepage E, Bastion Y, Tilly H, Bosly A, et al. Placebo-controlled phase III study of lenograstim glycosylated recombinant human granulocyte colony-stimulating factor ; in aggressive non-Hodgkin's lymphoma: Factors influencing chemotherapy administration. Leuk Lymphoma 1997; 25: 289-300. Negoro S, Masuda N, Furuse K, Saijo N, Fukuoka M. Dose-intensive chemotherapy in extensivestage small-cell lung cancer. Cancer Chemother Pharmacol 1997; 40: S70-3. 14. Zinzani PL, Pavone E, Storti S, Moretti L, Fattori PP, Guardigni L, et al. Randomized trial with or without granulocyte colony-stimulating factor as adjunct to induction VNCOP-B treatment of elderly high-grade non-Hodgkin's lymphoma. Blood 1997; 89: 3974-9. Dunlop DJ, Eatcock MM, Paul J, Anderson S, Reed NS, Soukop M, et al. Randomized multicentre trial of filgrastim as an adjunct to combination chemotherapy for Hodgkin's disease. Clin Oncol 1998; 10: 107-14. Foss SD, Kaye SB, Mead GM, Cullen M, de Wit R, Bodrogi I, et al. Filgrastim during combination chemotherapy of patients with poor-prognosis metastatic germ cell malignancy. J Clin Oncol 1998; 16: 716-24.
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The incumbent Australian operator, Telstra, has been one of the major investors in Vietnam, having been one of the first to take up the option of a BCC contract, as far back as 1988. The first contract committed OTC the former international operators arm, later integrated into Telstra ; to invest US$ 237 million over twelve years. The initial involvement included the provision of a satellite earth station in HCMC followed by an INTELSAT station in Hanoi. Subsequently Telstra helped install earth stations in other provinces and provided 45 VSATs Very Small Aperture Terminals ; . In 1990, OTC won the contract to handle the development and management of Vietnam's international services network, and later it extended this project to cover investment also in the domestic long-distance network. Part of the investment involved participation in the TVH Thailand-VietnamHongkong ; undersea cable. Relations between VNPT and its foreign partners received a set-back in 1996 when earlier plans to establish joint-ventures were reversed and instead the BCC contracts were offered. These were not perceived as being so beneficial to foreign investors and were indeed seen an highly risky, given the financial situation in the wider Asia region. Subsequently FDI declined see Box Figure 2.2 ; . Investment has picked up more recently, and Telstra was among the first foreign investors to return with an Internet Service Agreement with VDC in September 1998. Since the thawing of US-Vietnamese relations following President Clinton's November 2000 visit, Telstra will now face new competitors vying for VNPT's favour.
External links - filgrastim information from medline references myeloid growth factors and thrombopoietin and flu.
Stimulating Factor G-CSF ; are also used in neutropenia. These are two glycoproteins of the CSF family. GM-CSF is secreted by macrophages and stimulates stem cells to produce granulocytes neutrophils, eosinophils, and basophiles ; and macrophages. It is used as a medication trademarked Leukine ; , to stimulate the production of white blood cells, especially granulocytes and macrophages, following chemotherapy. G-CSF regulates haematopoietic cell proliferation and differentiation 7 ; . It produced by endothelium, macrophages, and other immune cells. There are two forms of the natural G-CSF: one of a 174 and other of a 180 amino-acid-long protein. The more-abundant and more-active form is the first one. This form is used in the development of pharmaceutical products by recombinant DNA rDNA ; technology. Australia was the country where G-CSF was first recognized and purified in 1983 mouse G-CSF ; , but the human G-CSF gene was cloned, for the first time, in Japan and United States three years later. There are two forms of recombinant human G-CSF. One is synthesized in an E. coli expression system, and it is called filgrastim. There are slight differences between the filgrastim and the natural glycoprotein. Filgrastim Neupogen ; and PEG-filgrastim Neulasta ; are two commercially available forms of rhGCSF recombinant human G-CSF ; . PEG means polyethylene glycol and it confers a much longer half-life, reducing the necessity of daily injections. The other form of recombinant human G-CSF, called lenograstim, is synthesized in Chinese Hamster Ovary cells CHO cells ; . Lenograstim is indistinguishable from the 174amino acid natural human G-CSF. No clinical or therapeutic consequences linked to the differences between filgrastim and lenograstim have yet been identified, but there are no formal comparative studies. Stem cells transplant SCT ; is an easier technique than the BMT with a longer life-span of transplanted cells. Stem cells are easier to harvest from umbilical cord ; 8 ; even from unrelated umbilical donor cord blood UCB ; when a suitable HLA-matched donor is not available. It was used in children with WiskottAldrich syndrome and other patients with malignant and nonmalignant disorders treated with myeloablative therapy 9 ; . There are UCB banks in many countries in the world for allogeneic unrelated and related SCT. UCB banks report available units to national and international donor registries. There is a second.
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At 31st December 2005, of the issued share capital, 167, 436, 200 shares were held in the ESOP Trust, 142, 779, 678 shares were held as Treasury shares and 5, 652, 635, shares were in free issue. All issued shares are fully paid and flucytosine.
22, 1994-people with a rare, potentially life-threatening blood disorder in which the body fails to manufacture sufficient infection-fighting white blood cells can now be treated with neupogen filgrastim ; , a biotechnology-derived product manufactured and marketed by amgen inc neupogen, a recombinant granulocyte colony-stimulating factor g-csf ; , was licensed for its third indication thursday by the food and drug administration fda ; as the first therapy indicated for treating the condition, severe chronic neutropenia scn ; , the company announced thursday and filgrastim.
Percy Hope earned his shot at a Triple Crown race by winning the 0, 000 Lone Star Derby two weeks after winning Turfway Park's Rushaway Stakes. The victory made him eligible for a million bonus if he won any Triple Crown race. Reinstedler passed on the Kentucky Derby to give his colt more time. In Percy Hope, Reinstedler had his second Triple Crown horse. His Knockadoon was seventh in the 1995 Derby and fourth in the Belmont Stakes. "It's really a treat to be around it, " Reinstedler said to The Courier-Journal of the Triple Crown races. "It's something you hope you have every year. But being a guy who only carries 15 or 20 horses, you don't know how many times you'll be blessed to do that." Percy Hope finished ninth in the 11-horse Preakness field and fludarabine.
In conclusion, the addition of filgrastim G-CSF ; to CHOP and CNOP reduces the incidence of severe granulocytopenia and infections requiring hospitalization. In the whole patient group G-CSF use did not significantly affect TTF, OS, or CR rate, although the cumulative proportion of patients receiving 90% or more of planned chemotherapy was moderately higher in the G-CSF group. CHOP was superior to CNOP with regard to TTF, DFS, OS, and CR rate.
Ings soaked with normal saline or 0.5% silver nitrate, systemic administration of antibiotics as per wound cultures, nutritional support, pulmonary and eye care, analgesics, anticoagulation, antacids, and or recently ; IVIG.9 Depending on the complications due to TEN, it is often necessary to provide ventilatory support, dialysis, transfusions, and or filgrastim treatment. Some patients require transfer to the intensive care unit. In the past, IVIG has been used to treat a number of autoimmune disorders, including dermatologic diseases such as dermatomyositis and pemphigus.14 It is known that IVIG modulates cytokine release, induces blockade of receptors, and inhibits Fas-mediated keratinocyte apoptosis.7 In 1998, Viard et al7 suggested that IVIG could be used to treat TEN. It works by inhibiting keratinocyte apoptosis triggered by interaction with cell surface death receptor Fas with FasL. In the study by Viard et al, 7 patients with TEN were treated with 0.2 to 0.75 g kg of IVIG every day for 4 days. This regimen was sufficient to cause resolution of TEN without any complications. Later, other case reports supported the use of IVIG to treat patients with TEN.15-20 In these cases, there was rapid improvement, shorter hospital stays, and no mortalities. Intravenous immunoglobulin treatment pro REPRINTED ; ARCH DERMATOL VOL 139, JAN 2003 42 and flumist.
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