RESUMO
AIMS: This open-label, phase I study evaluated the pharmacokinetics and safety of pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) for the treatment of chemotherapy-induced neutropenia in children with acute leukaemia. METHODS: PEG-rhG-CSF was administered as a single 100 mcg/kg (3 mg maximum dose) subcutaneous injection at the end of each chemotherapy period when neutropenia occurred. Blood samples were obtained from patients treated with PEG-rhG-CSF. PEG-rhG-CSF serum concentrations were determined by an enzyme-linked immunosorbent assay. Population pharmacokinetic (PPK) analysis was implemented using the nonlinear mixed-effects model. Short-term safety was evaluated through adverse events collection (registered at clinicaltrials.gov identifier: 03844360). RESULTS: A total of 16 acute leukaemia patients (1.8-13.6 years) were included, of whom two (12.5%) had grade 3 neutropenia, six (37.5%) had grade 4 neutropenia, and eight (50.0%) had severe neutropenia. For PPK modelling, 64 PEG-rhG-CSF serum concentrations were obtainable. A one-compartment model with first-order elimination was used for pharmacokinetic data modelling. The current weight was a significant covariate. The median (range) of clearance (CL) and area under the serum concentration-time curve (AUC) were 5.65 (1.49-14.45) mL/h/kg and 16514.75 (6632.45-54423.30) ng·h/mL, respectively. Bone pain, pyrexia, anaphylaxis and nephrotoxicity were not observed. One patient died 13 days after administration, and the objective assessment of causality was that an association with PEG-rhG-CSF was "possible". CONCLUSIONS: The AUC of PEG-rhG-CSF (100 mcg/kg, 3 mg maximum dose) in paediatric patients with acute leukaemia were similar to those of PEG-rhG-CSF (100 mcg/kg) in children with sarcoma. PEG-rhG-CSF is safe, representing an important therapeutic option for chemotherapy-induced neutropenia in paediatric patients with acute leukaemia.
Assuntos
Leucemia Mieloide Aguda , Neutropenia , Criança , Fator Estimulador de Colônias de Granulócitos/efeitos adversos , Humanos , Leucemia Mieloide Aguda/tratamento farmacológico , Neutropenia/induzido quimicamente , Polietilenoglicóis/efeitos adversos , Proteínas RecombinantesRESUMO
The interaction between nuclear graphite and molten fluoride salts (46.5 mol % LiF/11.5 mol % NaF/42 mol % KF) is investigated by synchrotron X-ray diffraction and C K-edge X-ray absorption near-edge structure (XANES). It is found that there are a large number of H atoms in IG-110 nuclear graphite, which is attributed to the residual C-H bond after the graphitization process of petroleum coke and pitch binder. The elastic recoil detection analysis indicates that H atoms are uniformly distributed in IG-110 nuclear graphite, in excellent agreement with the XANES results. The XANES results indicate that the immersion in molten fluoride salts at 500 °C led to H atoms in nuclear graphite partly substituted by the fluorine from fluoride salts to form C-F bond. The implications of these findings are discussed.