Effects of Recombinant Human Granulocyte Colony-Stimulating Factor Filgrastim on ECG Parameters in Neutropenic Patients
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Background and objective: Human granulocyte colony-stimulating factor (G-CSF) is a haematopoietic hormone that promotes the growth, proliferation, differentiation and maturation of neutrophil precursors. Filgrastim is a recombinant human G-CSF. Myocardial infarction, atrial fibrillation and arrhythmia have been reported in several patients with malignancy receiving filgrastim, but a causal relationship with the drug has not been established. The purpose of this study was to investigate the changes in ECG parameters in neutropenic patients during treatment with filgrastim.
Methods: This was a single-centre, prospective study carried out in a hospital emergency room. Patients with neutropenia and malignancy who were required to receive filgrastim were eligible for the study. After a reference ECG had been obtained, filgrastim was administered to all patients at a dose of 5 µg/kg/day subcutaneously for 2 days. Follow-up ECGs were then obtained at 12-hourly intervals. Continuous telemetric monitoring was conducted throughout hospitalization.
Results: Serial ECG parameters were compared in 102 patients. There were no statistically significant differences between baseline and follow-up ECG measurements of rhythm, P-wave duration, PR interval, QRS-wave duration, corrected QT (QTc) interval, ECG axis, premature supraventricular events, ventricular arrhythmia, R-wave progression, right bundle branch block or left bundle branch block. There was a significant reduction in mean heart rate in subsequent ECGs compared with baseline (p≪0.05).
Conclusion: This study did not demonstrate any ECG changes other than a significant reduction in mean heart rate in this selected population of neutropenic patients given 2 days’ treatment with subcutaneous 5 µg/kg/day of filgrastim.
KeywordsFebrile Neutropenia Filgrastim Left Bundle Branch Block Neutropenic Patient Right Bundle Branch Block
No sources of funding were used to assist in the preparation of this study. The authors have no conflicts of interest that are directly relevant to the content of this study.
- 2.Filgrastim. AHFS drug information [online]. Available from URL: http://www.medicinescomplete.com/mc/ahfs/current/ a392033.htm [Accessed 2008 May 29]Google Scholar
- 10.Conti JA, Scher HI. Acute arterial thrombosis after escalated-dose methotrexate, vinblastin, doxorubicin, and cisplatin chemotherapy with recombinant granulocyte colony-stimulating factor: a possible new recombinant granulocyte colony-stimulating factor toxicity. Cancer 1992; 70(11): 2699–702PubMedCrossRefGoogle Scholar
- 12.Amgen. Neupogen® (filgrastim) [prescribing information]. Thousand Oaks (CA): Amgen, 2004 Dec 20Google Scholar