**6. Oral carbon adsorbents as an addition to classical treatment of leukopenia with G-CSF**

Abovementioned positive results led us to design of a new improved version of carbon oral adsorbent, which was used in early experiments [64, 68]. An old prototype C1 and his new version C2 were approved on the model of melphalan-induced bone marrow suppression [69–71]. We demonstrated that myeloprotective action of carbon granulated enterosorbent С1 (bulk density of 0.28 g/cm3 , specific surface of 1719 m2 /g and mesopore area of 239 m2 /g) is significantly less compared to effects of adsorbent C2 with bulk density of 0.18 g/cm3 , total specific surface of 2162 m2 /g and mesopore area of 565 m2 /g (**Figure 14**).

#### **Figure 14.**

*White blood cells and neutrophils counts (109 /L) on the 8th day after melphalan injection at the dose of 3 mg/ kg and administration of oral carbon adsorbents C1 and C2 in a study on rats. Notes. \*—p < 0.05 compared to the control group; \*\*—p < 0.05 compared to the melphalan group; #—p < 0.05 and compared to the Melphalan + C1group.*

#### **Figure 15.**

*White blood cells count (109 /L) on the 8th day after melphalan injection at the dose of 4 mg/kg and administration of oral carbon adsorbent and filgrastim in the study on rats. Notes. p < 0.05 compared to: \*— Control group; \*\*—Melphalan group; \*\*\*—Melphalan + C2 group; \*\*\*\*—Melphalan + filgrastim group.*

**227**

**7. Conclusions**

**Figure 16.**

*Neutrophils count (109*

*\*\*—Melphalan group.*

*Sorption Detoxification as an Addition to Conventional Therapy of Acute Radiation Sickness…*

C2 enterosorbent administration normalized the prooxidant/antioxidant system indices too [71]. Oxidative stress is an intrinsic part of ionizing radiation and radiomimetic injury, and enteral sorption therapy possesses notable antioxidant effects. Adding the carbon oral adsorbent to classical scheme for the treatment of leukopenia with G-CSF (caused by single intravenous melphalan injection at the dose of 4 mg/kg) demonstrated significant myeloprotective effect and synergy compared to single-use effects of each agent alone [70] (**Figures 15** and **16**). C2 and filgrastim combination caused increase of white blood cells count by 138.3% compared to the melphalan group; by 65.8% compared to melphalan + C2 group, and by 51.7%

*of oral carbon adsorbent and filgrastim in a study on rats. Notes. p < 0.05 compared to: \*—Control group;* 

*/L) on the 8th day after melphalan injection at the dose of 4 mg/kg and administration* 

We must note that in this study, we got an unexpected significant increase of

Use of enterosorbent or combined use of both preparations provided signifi-

The important issue is that combination of G-CSF and carbon adsorbents [69] as well as enteral sorption therapy use alone [65] does not affect the efficacy of anticancer treatment; we proved it by our experiments on Guerin tumor-grafted rats.

Leukopenia is an essential part of the damage caused by ionizing irradiation and/or radiomimetic influences (as tumoricidal chemotherapy). Leukocytes play an important role in immune defense, tissue regeneration, the functioning of the main organs and systems; and the degree of bone marrow suppression determines the survival of victims in ionizing radiation exposure as well as the efficacy of anticancer chemotherapy. All three methods of sorption detoxification with activated carbons such as hemoperfusion (when blood is filtered through the column with activated carbon); enterosorption—peroral use of oral adsorbents and applicationsorption therapy (use of carbon dressing for the healing of the burns and wounds), can be successfully used for the leukopenia prophylaxis and treatment in ionizing irradiation exposure, side effects of anti-cancer chemotherapy, as well as for the

that received the combined treatment with oral adsorbent and G-CSF. Isolated administration of enterosorbent C2 tended to raise the level of thrombocytes, we

cantly better effects toward the prooxidant/antioxidant balance in rats.

/L in a group of rats

platelets level from (254.60 ± 45.59) to (505.40 ± 70.68) × 109

suppose because of general detoxification action.

boosting of healing of associated skin damage.

*DOI: http://dx.doi.org/10.5772/intechopen.85690*

compared to use of filgrastim alone.

*Sorption Detoxification as an Addition to Conventional Therapy of Acute Radiation Sickness… DOI: http://dx.doi.org/10.5772/intechopen.85690*

**Figure 16.**

*Cells of the Immune System*

**leukopenia with G-CSF**

and mesopore area of 239 m2

area of 565 m2

C2 with bulk density of 0.18 g/cm3

*White blood cells and neutrophils counts (109*

/g (**Figure 14**).

**6. Oral carbon adsorbents as an addition to classical treatment of** 

granulated enterosorbent С1 (bulk density of 0.28 g/cm3

Abovementioned positive results led us to design of a new improved version of carbon oral adsorbent, which was used in early experiments [64, 68]. An old prototype C1 and his new version C2 were approved on the model of melphalan-induced bone marrow suppression [69–71]. We demonstrated that myeloprotective action of carbon

, specific surface of 1719 m2

/g and mesopore

/g) is significantly less compared to effects of adsorbent

*/L) on the 8th day after melphalan injection at the dose of 3 mg/*

, total specific surface of 2162 m2

*/L) on the 8th day after melphalan injection at the dose of 4 mg/kg and* 

*administration of oral carbon adsorbent and filgrastim in the study on rats. Notes. p < 0.05 compared to: \*— Control group; \*\*—Melphalan group; \*\*\*—Melphalan + C2 group; \*\*\*\*—Melphalan + filgrastim group.*

*kg and administration of oral carbon adsorbents C1 and C2 in a study on rats. Notes. \*—p < 0.05 compared to the control group; \*\*—p < 0.05 compared to the melphalan group; #—p < 0.05 and compared to the* 

/g

**226**

**Figure 15.**

**Figure 14.**

*Melphalan + C1group.*

*White blood cells count (109*

*Neutrophils count (109 /L) on the 8th day after melphalan injection at the dose of 4 mg/kg and administration of oral carbon adsorbent and filgrastim in a study on rats. Notes. p < 0.05 compared to: \*—Control group; \*\*—Melphalan group.*

C2 enterosorbent administration normalized the prooxidant/antioxidant system indices too [71]. Oxidative stress is an intrinsic part of ionizing radiation and radiomimetic injury, and enteral sorption therapy possesses notable antioxidant effects.

Adding the carbon oral adsorbent to classical scheme for the treatment of leukopenia with G-CSF (caused by single intravenous melphalan injection at the dose of 4 mg/kg) demonstrated significant myeloprotective effect and synergy compared to single-use effects of each agent alone [70] (**Figures 15** and **16**). C2 and filgrastim combination caused increase of white blood cells count by 138.3% compared to the melphalan group; by 65.8% compared to melphalan + C2 group, and by 51.7% compared to use of filgrastim alone.

We must note that in this study, we got an unexpected significant increase of platelets level from (254.60 ± 45.59) to (505.40 ± 70.68) × 109 /L in a group of rats that received the combined treatment with oral adsorbent and G-CSF. Isolated administration of enterosorbent C2 tended to raise the level of thrombocytes, we suppose because of general detoxification action.

Use of enterosorbent or combined use of both preparations provided significantly better effects toward the prooxidant/antioxidant balance in rats.

The important issue is that combination of G-CSF and carbon adsorbents [69] as well as enteral sorption therapy use alone [65] does not affect the efficacy of anticancer treatment; we proved it by our experiments on Guerin tumor-grafted rats.
