Chemotherapeutic treatment of cancer comes with side effects on the immune system, such as Chemotherapy‐Induced Neutropenia (CIN). A recombinant form of Granulocyte Colony‐Stimulating Factor (G‐CSF) has been used to alleviate CIN. This is a challenging task due to the feedback complexity of the hematological system. A System Dynamics model is constructed to study this system and to derive practical insights for the management of CIN. Stimulation of neutrophil production via G‐CSF is observed to propose crucial trade‐offs. On one hand, production by stem cells and mobilization from bone marrow should be stimulated to compensate for the impairment caused by chemotherapy. On the other hand, it is important to avoid overstimulation, which reduces the regenerative capacity, as well as draining the much‐needed bone‐marrow reservoir. Our analysis supports the intuition that the response to G‐CSF administration is conditional to patient characteristics, and “one for all” treatment protocols are impractical. © 2021 System Dynamics Society

中文翻译：

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化疗期间粒细胞集落刺激因子（G-CSF）管理的动态取舍

癌症的化学疗法治疗会对免疫系统产生副作用，例如化学疗法诱导的中性粒细胞减少症（CIN）。重组形式的粒细胞集落刺激因子（G-CSF）已用于缓解CIN。由于血液系统的反馈复杂性，这是一项具有挑战性的任务。构建了系统动力学模型来研究该系统并为CIN管理提供实用见解。观察到通过G-CSF刺激嗜中性白细胞的产生提出了关键的权衡。一方面，应刺激干细胞的产生和骨髓的动员，以补偿化学疗法引起的损害。另一方面，重要的是要避免过度刺激，这会降低再生能力，并排掉急需的骨髓储库。我们的分析支持这样的直觉，即对G-CSF给药的反应取决于患者的特征，因此“一劳永逸”的治疗方案是不切实际的。©2021系统动力学学会