Grasalva treatment of primary and secondary immune neutropenia in children
Granulocyte colony-stimulating factor is an effective first-line therapy for immune and idiopathic neutropenia. We evaluated the efficiency and safety of Grasalva* (TEVA, Israel), a new bioanalog of filgrastim, in the treatment of 16 children aged from 8 months to 14 years with primary and secondary immune and idiopathic neutropenias. The reference group consisted of 10 patients of the same age with primary autoimmune neutropenia, treated by Neupogen<sup>®</sup>, original filgrastim drug. The mean number of Grasalva injections needed for maintaining neutrophil count at the level of at least 1000/µl was virtually the same as that in the Neupogen group (10.2 ± 1.39 and 9.3 ± 1.8, respectively; p > 0.05). Grasalva treatment was associated with a significant reduction in the incidence of infectious episodes: 3.5 ± 0.4 before therapy and 0.33 ± 0.3 during and after therapy (p < 0.001). The incidence of adverse effects observed in Grasalva therapy group (local reactions -short-term hyperemia at the site of injection in 4.5 % cases and systemic reactions - headache and pain in the bones in 1.3 % cases) was virtually the same as in patients treated by Neupogen (local reactions in 4.3 % cases and systemic reactions in 2.1 % cases; p = 0.5). Grasalva is recommended for the treatment of immune neutropenia in children with infectious manifestations.