抄録
Pancreatic cancer is one of the most resistant malignancies and operations, radiotherapy and chemotherapy have all been widely used for the treatment of this disease. Gemcitabine, a new drug against pancreatic cancer, has been accepted for use in a palliative setting in Japan since April 2001. It is highly important for pharmacists to check for adverse effects of new drugs, especially in the case of chemotherapeutic agents, because these agents may exhibit many serious adverse effects such as hematologic toxicity that could be fatal to patients.
In this study, we investigated the adverse effects of gemcitabine to improve the pharmaceutical care of patients with pancreatic cancer. In a survey of adverse effects, severe leukopenia was observed in most patients. G-CSF (granulocyte colony-stimulating factor) has been commonly used as a therapeutic agent for leukopenia, and its major principal action is to stimulate the proliferation, differentiation, and function of the granulocyte lineage in the peripheral blood. Another action is to cause marrow stem cells to migrate into the peripheral blood. Because of this latter action, it is advised that G-CSF should not be given concurrently with chemotherapeutic agents, and should be discontinued at least 24 hours before and after the administration of chemotherapeutic agents. Since there have been some patients in whom G-CSF was administered within 24 hors of gemcitabine treatment, we provided drug information about the optimal usage of G-CSF to doctors concerned. As a result, a normal level of leukocytes could be maintained, and the usage of G-CSF was decreased.
In conclusion, we confirmed that leukopenia is the major adverse effect of gemcitabine in pancreatic cancer patients, and demonstrated that the appropriate use of G-CSF for the treatment of gemcitabine-induced leukopenia makes this chemotherapy both safer and more economical.
