Rituximab and Filgrastim / Neupogen

[ukxmrv]

Does anyone have any experience of combining Rituximab with injections of Filgrastim / Neupogen?

I've been in touch with a couple of cancer patients with ME recently. One had complete remission of their ME symptoms for 5 months after treatment with Rituximab. The good effects started very quickly and they felt better on chemotherapy than they did with normal ME symptoms.

The other patient didn't have any positive effects on their ME symptoms with Rituximab but due to getting repeated infections they had injections of Filgrastim during chemo to boost their white blood cells.

Would the Filgrastim affect the B cells depletion to the extent that it would not have the positive effects for ME symptoms?

 

[JES]

Not sure I understand what the point would be of combining Rituximab with Filgrastim, assuming that it removes the positive effects. Certainly no one here can afford testing that. Currently even the optimal Rituximab protocol for CFS/ME is unknown, anyone lucky enough to get Ritux would certainly not play around with co-administering other drugs at the same time. We simply know too little on how it works for CFS/ME at this point.

 

[Jonathan Edwards]

Does anyone have any experience of combining Rituximab with injections of Filgrastim / Neupogen?

I've been in touch with a couple of cancer patients with ME recently. One had complete remission of their ME symptoms for 5 months after treatment with Rituximab. The good effects started very quickly and they felt better on chemotherapy than they did with normal ME symptoms.

The other patient didn't have any positive effects on their ME symptoms with Rituximab but due to getting repeated infections they had injections of Filgrastim during chemo to boost their white blood cells.

Would the Filgrastim affect the B cells depletion to the extent that it would not have the positive effects for ME symptoms?

Filgrastim is G-CSF, which stimulates recovery of neutrophils if these are low. They are often low with broad spectrum cytotoxic chemotherapy but rituximab does not usually lower neutrophils. Very occasionally neutrophils go down some months after rituximab but usually no treatment is needed. To be honest I cannot see what the relevance of filgrastim to rituximab treatment is. I think you may be suggesting that somehow it might offset the effect of rituximab on B cells but it has no effect on this.