World J Oncol

World Journal of Oncology, ISSN 1920-4531 print, 1920-454X online, Open Access

Article copyright, the authors; Journal compilation copyright, World J Oncol and Elmer Press Inc

Journal website http://www.wjon.org

Original Article

Volume 6, Number 4, August 2015, pages 410-415

1-Pamitoyl-2-Linoleoyl-3-Acetyl-rac-Glycerol May Reduce Incidence of Gemcitabine-Induced Neutropenia: A Pilot Case-Controlled Study

Figures

Figure 1. Structure of synthetic PLAG.

Figure 2. Trends in ANCs over the courses of chemotherapy between PLAG and control groups. The ANCs of PLAG group significantly less decreased from the baseline level compared to those of control group and this significant difference in reduction percentage of ANCs between the two groups was sustained throughout the courses of chemotherapy. Mean ± SE: mean ± standard error of mean. ANC: absolute neutrophil count; IANC: baseline neutrophil count prior to chemotherapy; ANC1: ANC obtained just prior to second time gemcitabine injection; ANC2: ANC obtained just prior to third time gemcitabine injection; ANC5: ANC obtained just prior to sixth time gemcitabine injection; ANC 8: ANC obtained just prior to ninth time gemcitabine injection.

Figure 3. The distribution of chemotherapy-induced neutropenic patients according to the degree of neutropenia; the incidence of grade 2-4 neutropenia was significantly lower among patients who received PLAG compared to control group. Grade 4 neutropenia developed only in the control group.

Tables

**Table 1.** Baseline Characteristics of Patients
	PLAG group (N = 16)	Control group (N = 32)
Male/female	7:9	23:9
Median age (years, range)	56.5 (44 - 72)	59 (44 - 69)
Chemotherapy cycle
Two cycles	8	16
Three cycles	8	16
Cancer stage
Locally advanced	6	12
Metastatic	10	20
ECOG performance
Grade 1	16	32

**Table 2.** Clinical Outcomes of Patients
Absolute neutrophil count (ANC) or %	PLAG group (N = 16)	Control group (N = 32)	P-value
ANC < 1,500 (grade 2 or higher)	6 (37.5%)	26 (81.3%)	P < 0.05
Depth of the ANC nadir > 50% of baseline level	6 (37.5%)	29 (90.6%)	P < 0.05
Depth of the ANC nadir > 75% of baseline level	0	12 (37.5%)	P < 0.05

**Table 3.** Comparison of PLAG and Long-Acting G-CSF for the Prevention of Chemotherapy-Induced Neutropenia
	Long-acting G-CSF (pegfilgrastim)	PLAG
Route of administration	Parenteral (subcutaneous injection)	Per oral
Administration mode	Once per chemotherapy cycle	Daily administration continuing throughout the course of chemotherapy
Timing of starting administration	Recommended to be administered 24 h after chemotherapy completion	Can be safely administered prior to or simultaneously with the initiation of chemotherapy
Side effects	Bone pain, fatigue, nausea, headache, splenic rupture, etc.	Not observed