9 juni 2013: Helpt neupogen of neulasta wel tegen neutropenie - tekort aan witte bloedlichaampjes - veroorzaakt door chemo? En zijn er niet toxische natuurlijke alternatieven voor?

Chemo veroorzaakt vaak neutropenie, een vermindering van de witte bloedlichaampjes. Vaak krijgen wij de vraag wat kun je daartegen doen. Zijn er natuurlijke middelen die dit tegen kunnen gaan? In de reguliere oncologie wordt dan vaak neupogen - filgrastim of nog beter werkzaam neulasta - pegfilgrastim toegediend., een kunstmatige vorm van G-CSF  (kolonie stimulerende factor).

Orthomoleculaire artsen zeggen dat ook niet toxische natuurlijke middelen neutropenie kan tegengaan, maar welke middelen en voedingstoffen dat zijn lijkt het me beter dat u daarvoor een goed gekwalificeerde orthomoleculaire arts consulteert want ik denk dat dit bij elke persoon en ook wel per chemo en vorm van kanker kan verschillen. We horen van veel patiënten dat chemosupport - een mix van bepaalde kruiden -  van de natuurapotheek de bijwerkingen van chemo tegengaat bij met name chemo bij darmkanker, maar ook hiervoor raadpleeg aub de natuurapotheek zelf of een arts.

Dat Filgrastim en vooral Pegfilgrastim invloed heeft op de effectiviteit van de chemokuren en wel of niet optreden van neutropenie en zelfs op de mediane overleving wordt beschreven in een grote review studie uit 2011 Granulocyte colony-stimulating factors for febrile neutropenia prophylaxis following chemotherapy: systematic review and meta-analysis  gepubliceerd in BMD Cancer - BioMed Central Cancer en het volledige studierapport is gratis in te zien. Onderaan dit artikel staat abstract van deze studie plus een referentielijst van studies naar dit onderwerp

Wat is filgrastim? Bron: Apotheek.nl:

Filgrastim (Neupogen) wordt onder andere gebruikt bij mensen die een beenmergtransplantatie ondergaan, om de tijd te overbruggen tot het beenmerg voldoende witte bloedcellen aanmaakt. Verder bij mensen met een tekort aan witte bloedcellen, als aangeboren ziekte of veroorzaakt door geneesmiddelen, door hiv-aids (zie hierna) of door chemotherapie (zie hierna). Dit middel wordt ook gebruikt bij gezonde mensen om de aanmaak van witte bloedcellen te stimuleren, die dan bij hen via de bloedbaan worden afgenomen om te doneren aan iemand die tekort aan deze bloedcellen heeft.

Wat is pegfilgrastim? Bron: Oncolink.org

Pegfilgrastim (Neulasta) is een zogeheten kolonie stimulerende factor en valt in een groep van geneesmiddelen die de productie en functie van bloedcellen, waaronder witte bloedcellen, rode bloedcellen en bloedplaatjes stimuleren. Granulocyt kolonie-stimulerende factor (G-CSF) is een eiwit dat door het lichaam wordt geproduceert om de productie van witte bloedcellen te verhogen. Pegfilgrastim is een langwerkende, kunstmatige versie van G-CSF dat de productie van witte bloedcellen en in het bijzonder neutrofielen stimuleert.
Een neutrofiel is een type witte bloedcel dat verantwoordelijk is voor de bestrijding van infecties en de aanwezige neutrofielen worden vaak verminderd tijdens chemokuren in een behandeling van kanker. Wanneer het aantal van deze cellen beneden 1000/mm3, wordt dit neutropenie genoemd en heeft de patiënt een vergroot risico op infecties.
Pegfilgrastim wordt gebruikt om neutropenie gerelateerd aan chemotherapie te voorkomen of te behandelen.

Primary prophylaxis with G-CSFs significantly reduces FN incidence in adults undergoing chemotherapy for solid tumours or lymphoma. Pegfilgrastim reduces FN incidence to a significantly greater extent than filgrastim.

BMC Cancer. 2011; 11: 404.
Published online 2011 September 23. doi:  10.1186/1471-2407-11-404
PMCID: PMC3203098

Granulocyte colony-stimulating factors for febrile neutropenia prophylaxis following chemotherapy: systematic review and meta-analysis

 

Abstract

Background

Febrile neutropenia (FN) occurs following myelosuppressive chemotherapy and is associated with morbidity, mortality, costs, and chemotherapy reductions and delays. Granulocyte colony-stimulating factors (G-CSFs) stimulate neutrophil production and may reduce FN incidence when given prophylactically following chemotherapy.

Methods

A systematic review and meta-analysis assessed the effectiveness of G-CSFs (pegfilgrastim, filgrastim or lenograstim) in reducing FN incidence in adults undergoing chemotherapy for solid tumours or lymphoma. G-CSFs were compared with no primary G-CSF prophylaxis and with one another. Nine databases were searched in December 2009. Meta-analysis used a random effects model due to heterogeneity.

Results

Twenty studies compared primary G-CSF prophylaxis with no primary G-CSF prophylaxis: five studies of pegfilgrastim; ten of filgrastim; and five of lenograstim. All three G-CSFs significantly reduced FN incidence, with relative risks of 0.30 (95% CI: 0.14 to 0.65) for pegfilgrastim, 0.57 (95% CI: 0.48 to 0.69) for filgrastim, and 0.62 (95% CI: 0.44 to 0.88) for lenograstim. Overall, the relative risk of FN for any primary G-CSF prophylaxis versus no primary G-CSF prophylaxis was 0.51 (95% CI: 0.41 to 0.62). In terms of comparisons between different G-CSFs, five studies compared pegfilgrastim with filgrastim. FN incidence was significantly lower for pegfilgrastim than filgrastim, with a relative risk of 0.66 (95% CI: 0.44 to 0.98).

Conclusions

Primary prophylaxis with G-CSFs significantly reduces FN incidence in adults undergoing chemotherapy for solid tumours or lymphoma. Pegfilgrastim reduces FN incidence to a significantly greater extent than filgrastim.

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