Several other phase 1/2 studies‚ which did not directly measure the incidence of infection‚ but which did measure increases in neutrophils‚ support the efficacy of NEUPOGEN ® . The regimens are presented to provide some background on the clinical experience with NEUPOGEN ® . No claim regarding the safety or efficacy of the chemotherapy regimens is made. The effects of NEUPOGEN ® on tumor growth or on the anti-tumor activity of the chemotherapy were not assessed. The doses of NEUPOGEN ® used in these studies are considerably greater than those found to be effective in the phase 3 study described above. Such phase 1/2 studies are summarized in the following table.
Approach to lymphocytosis: ALC>4000/uL
It's either reactive or clonal:
- viral: HIV (in acute infection), EBV (mono), CMV, HHV6, HTLV-1
- bac: bordatella pertussis, bartonella (cat scratch disease)
- toxo, babesiosis (also causes hemolytic anemia)
2) Hypersensitivity reactions
- drugs, acute serum sickness
3) stress-induced (status epilepticus, trauma)
4) post splenectomy
5) polyclonal B cell lymphocytosis
3) LGL leukemia
The left shift response of granulocytes describes the reaction of the bone marrow to a stimulus that is prompting leukocytosis. There is an increase in the proportion of immature leukocytes released from post-mitotic stores. Hence, on a graph of absolute number of leukocytes (y-axis) against number of lobes of nucleus in leukocytes (x-axis), there is a shift in the curve upwards and to the left with leukocytosis relative to normal.