The ability of filgrastim to mitigate mortality following LD50/60 total-body irradiation is administration time-dependent

Ann M. Farese, Cassandra R. Brown, Cassandra P. Smith, Allison M. Gibbs, Barry Katz, Cynthia S. Johnson, Karl L. Prado, Thomas J. Macvittie

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

ABSTRACT: The identification of the optimal administration schedule for an effective medical countermeasure is critical for the effective treatment of individuals exposed to potentially lethal doses of radiation. The efficacy of filgrastim (Neupogen®), a potential medical countermeasure, to improve survival when initiated at 48 h following total body irradiation in a non-human primate model of the hematopoietic syndrome of the acute radiation syndrome was investigated. Animals were exposed to total body irradiation, antero-posterior exposure, total midline tissue dose of 7.5 Gy, (target lethal dose 50/60) delivered at 0.80 Gy min, using linear accelerator-derived 6 MV photons. All animals were administered medical management. Following irradiation on day 0, filgrastim (10 μg kg d) or the control (5% dextrose in water) was administered subcutaneously daily through effect (absolute neutrophil count ≥ 1,000 cells μL for three consecutive days). The study (n = 80) was powered to demonstrate a 25% improvement in survival following the administration of filgrastim or control beginning at 48 ± 4 h post-irradiation. Survival analysis was conducted on the intention-to-treat population using a two-tailed null hypothesis at a 5% significance level. Filgrastim, initiated 48 h after irradiation, did not improve survival (2.5% increase, p = 0.8230). These data demonstrate that efficacy of a countermeasure to mitigate lethality in the hematopoietic syndrome of the acute radiation syndrome can be dependent on the interval between irradiation and administration of the medical countermeasure.

Original languageEnglish
Pages (from-to)39-47
Number of pages9
JournalHealth Physics
Volume106
Issue number1
DOIs
StatePublished - Jan 2014

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Aptitude
Whole-Body Irradiation
Lethal Dose 50
Acute Radiation Syndrome
Mortality
Particle Accelerators
Survival Analysis
Photons
Primates
Appointments and Schedules
Neutrophils
Filgrastim
Radiation
Glucose
Water
Population

Keywords

  • blood
  • laboratory animals
  • radiation
  • whole body irradiation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Health, Toxicology and Mutagenesis
  • Epidemiology

Cite this

The ability of filgrastim to mitigate mortality following LD50/60 total-body irradiation is administration time-dependent. / Farese, Ann M.; Brown, Cassandra R.; Smith, Cassandra P.; Gibbs, Allison M.; Katz, Barry; Johnson, Cynthia S.; Prado, Karl L.; Macvittie, Thomas J.

In: Health Physics, Vol. 106, No. 1, 01.2014, p. 39-47.

Research output: Contribution to journalArticle

Farese, Ann M. ; Brown, Cassandra R. ; Smith, Cassandra P. ; Gibbs, Allison M. ; Katz, Barry ; Johnson, Cynthia S. ; Prado, Karl L. ; Macvittie, Thomas J. / The ability of filgrastim to mitigate mortality following LD50/60 total-body irradiation is administration time-dependent. In: Health Physics. 2014 ; Vol. 106, No. 1. pp. 39-47.
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