In this chapter, we will discuss drugs and potential drugs (often referred to as agents) that may be used before chemotherapy to reduce the side effects. These drugs/agents are often referred to as chemoprotectors. Examples of chemoprotectors are listed below based on the individual targets to be protected.
1. Drugs to Increase White Blood Cell Count
Filgrastim
Filgrastim is a 175-amino acid human granulocyte colony-stimulating factor (G-CSF) manufactured by recombinant DNA technology in E Coli. It is a glyprotein naturally produced by a number of different tissues to stimulate the bone marrow cells to produce granulocytes and release them into the blood.
Filgrastim is used to stimulate the proliferation and differentiation of neutrophils, which are the most abundant type of WBCs. It is marketed as Neupogen® by Amgen, as Religrast® by Reliance Biopharmaceuticals, and as ShilgrastTM by Raichem Lifesciences.
Sargramostim
Sargramostim is a WBC stimulant sold as Leukine® by Genzyme. It is a human granulocyte macrophage colony stimulating factor (GM-CSF) produced by recombinant DNA technology in a yeast, S. cerevisiae. Sargramostim is a glycoprotein having 127 amino acids. Its amino acid sequence is different from the natural human GM-CSF by a substitution of leucine at position 23. It was originally approved by the FDA in March, 1991 for use following autologous bone marrow transplantation (BMT) and was approved in December 1991 to prevent death following BMT engraftment delay or failure. In September of 1995, it was subsequently licensed to shorten the time for neutrophil recovery to prevent early death from life- threatening infections following chemotherapy for older patients suffering from acute myelogenous leukemia (AML).
© Jiajiu Shaw, 2023
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