Filgrastim for Hematologic Neoplasms

Hematologic neoplasms are a group of cancer types involving blood-forming tissue that are frequently caused by genetic inheritance, exposure to ionizing radiation or to environmental toxins (e.g., medications), or a combination thereof. Hematologic neoplasms include benign hemoproliferative disorders, hematologic malignancies, and blood disorders with hemolysis, such as aplastic anemia and hemolytic anemias, among others. Hematologic Neoplasms-Cancer and Hematologic Neoplasms-Blood Disorders category is used in the CSC classification. For the most part, the current WHO classification is still used in the classification of leukemias, HLH and Lymphomas.

Hematologic lesions in adults cause many of the same signs and symptoms as those of more well defined lesions in children. The differential diagnosis of hematologic lesions depends on the sites that are involved by the neoplasms. The exact presentation and natural history of each hematologic lesion is determined by its anatomic site of appearance, specific pathologic processes, and distribution of affected cells.

Treatment for hematologic neoplasms varies depending on the type of tumor. The treatment may use combinations of different approaches. Combining treatments is preferable to monotherapy in some types of leukemia or in cases of aggressive treatment of aplastic anemia. Treatment-related bone marrow depletion is an example of a complication that is common in patients who suffer from hematologic neoplasms.

There are approximately 1,600 new diagnoses of acute myeloid leukemia, 1,550 of hairy cell leukemia, 800 of chronic myelogenous leukemia a year in the US. The incidence of Langerhans cell histiocytosis is about 1,300 per year. Non-Hodgkin lymphoma incidence in the US is approximately 5,500 per year. Acute lymphoblastic leukemia of childhood is approximately 500 per year. Chronic lymphocytic leukemia of childhood is about 75 per year. Hodgkin disease of childhood is approximately 500 per year. The number of new diagnoses of acute myelogenous leukemia in the US has been stable over the past decade.

Aspiration of contaminated thymus or bone marrow may cause hematologic neoplasms. The exact risk from contaminated thymus depends on the patient's age. In children this risk is greater than in adults, but in both groups, the disease occurs at earlier stages. Blood cells are not necessary for the development of hematologic neoplasms, and it appears that many hematologic neoplasms are asymptomatic early in life, with symptoms developing later in life.

Hematological malignancies can be cured only in relatively rare cases that are cured by a combination of radiotherapy, chemotherapy, or hematopoietic stem-cell transplantation. Other types of malignancies do not appear to be curable according to the current clinical data.

The following variables, including age, sex, blood type, and presence of a family history, were associated with an increased risk of developing hematologic malignancies: leukemia, lymphoma, or multiple myeloma.

There are many options for filgrastim treatment combinations. Filgrastim treatment may be given on its own, with other intravenous antibiotics in cases of infections, with cytotoxic chemotherapeutic agents, or with other stem cell support. Filgrastim is often combined with granulocyte colony-stimulating factor in treatment plans.

Filgrastim has few common side effects, and these can be managed by decreasing the infusion rate, by delaying the start of infusion if side effects are present, or by holding infusion until the side effects subside. It is important to be aware of these common side effects of filgrastim and to consult a treatment-specific list. For a complete list of serious or otherwise side effects, see Filgrastim Side Effects.

Filgrastim improved appetite, mood, and social interaction in patients with hematologic neoplasms. Filgrastim increased caloric intake and may have helped preserve patients' psychosocial and physical quality of life.

Most patients with hematologic cancers have a poor prognosis, and patients diagnosed in an academic center have worse results than patients in less fortunate settings. Some patients with hematologic malignancies may be candidates for future trials.