Изменение Кислородзависимой Антимикробной Активности Нейтрофилов У Больных Раком Молочной Железы При Терапии Филграстимом И Цефтриаксоном По Поводу Фебрильной Нейтропении

We compared generation of oxygen active forms by neutrophils in 10 patients with stage IV breast cancer who developed febrile neutropenia and were treated with filgrastim (recombinant human granulocyte colonystimulating factor, 5 mcg/kg, subcutaneously, once daily) and antibiotic ceftriaxone (2 g, intravenously, once daily) after 5-12 polychemotherapy cycles with or without radiotherapy (total tumor dose 40 Gy), and generation of oxygen active forms in 100 healthy individuals. Generation of oxygen active forms was measured by chemiluminescence before (0 h) and at 24, 72 and 144 h after the start of filgrastim and ceftriaxone therapy. Nonactivated neutrophil chemiluminescence parameters in breast cancer patients were significantly lower than normal before filgrastim therapy which was evidence of a considerable decrease in their functional activity. Generation of oxygen active forms was increasing on filgrastim and ceftriaxone therapy. Myeloperoxidasedependent generation of oxygen active forms was still increasing after therapy discontinuation while spontaneous chemiluminescence values were greater than those in healthy individuals. NADPH-dependent generation of oxygen active forms did not exceed the normal level though was higher than at baseline. The response was sustained for several days after therapy completion mainly for myeloperoxidase-dependent generation of oxygen active forms. Impairment of oxygen-dependent mechanisms of neutrophil antimicrobial activity is a predisposing factor to development of infectious complications in patients with neutropenia.