Based on preclinical studies, clinical development of SCF has been directed toward using the combination of recombinant human SCF (rHuSCF; ancestim) and rHuG-CSF (filgrastim) to increase the mobilization of PBPCs vs that obtained with rHuG-CSF alone, for harvesting and autologous transplantation after myeloablative therapy in patients with cancer. Results of these studies have been reviewed in detail (160). In several cancer patient populations, two- to threefold enhancement of mobilized and harvestable PBPCs was obtained. rHuSCF (ancestim) is approved in Canada, Australia, and New Zealand for use with rHuG-SCF (with or without PBPCs-mobilizing chemotherapy) to provide a sustained increase in the PBPCs capable of engraftment, to increase the proportion of patients reaching the PBPC target, and to reduce the number of leukaphereses required to collect a target number of PBPCs. Its use has not been approved in other regions, including the United States, Europe, and Japan.

Because of the potential for mast cell activation, the use of rHuSCF is contraindi-cated in patients with asthma, severe allergy, or other significant IgE-mediated hypersensitivity, and patients are given premedication with H1 and H2 antihistamines and a bronchodilator. Transient injection-site wheel-and-flare reactions with associated mast cell degranulation, and occasional (<10%) melanocyte-mediated injection-site hyper-pigmentation, occur. In approx 500 patients who received rHuSCF (with premedication) in clinical studies, severe but manageable systemic allergic-like reactions with cutaneous and respiratory involvement occurred at a frequency of approx 3%.

Coping with Asthma

Coping with Asthma

If you suffer with asthma, you will no doubt be familiar with the uncomfortable sensations as your bronchial tubes begin to narrow and your muscles around them start to tighten. A sticky mucus known as phlegm begins to produce and increase within your bronchial tubes and you begin to wheeze, cough and struggle to breathe.

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