Systemic non-steroidal anti-inflammatory drugs (NSAIDs) have been shown to reduce alveolar bone loss in periodontitis. This study assesses the efficacy of a topical NSAID rinse, containing ketorolac tromethamine as the active agent. Adult periodontitis patients (n = 55) were studied in this 6-month randomized, double blind, parallel, placebo and positive-controlled study. Each patient had a least 3 sites at high risk for bone loss as assessed by low dose bone scan. Groups, balanced for gender, were assigned to one of three regimens: bid ketorolac rinse (0.1%) with placebo capsule; 50 mg bid flurbiprofen capsule (positive control) with placebo rinse; or bid placebo rinse and capsule. Prophylaxes were provided every 3 months. Monthly examinations assessed safety, gingival condition, and gingival crevicular fluid PGE2. Standardized radiographs were taken at baseline and at 3 and 6 months for digital subtraction radiography. A significant loss in bone height was observed during the study period in the placebo group (-0.63 +/- 0.11; P < 0.001), but not in the flurbiprofen (-0.10 +/- 0.12; P = 0.40) or ketorolac rinse (+0.20 +/- 0.11 mm; P = 0.07) groups. Nested ANOVA revealed that ketorolac and flurbiprofen groups had less bone loss (P < 0.01) and reduced gingival crevicular fluid PGE2 levels (P < 0.03) compared to placebo. ANOVA suggests (P = 0.06) that ketorolac rinse preserved more alveolar bone than systemic flurbiprofen at the dose regimens utilized. These data indicate that ketorolac rinse may be beneficial in the treatment of adult periodontitis.

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Summary:A total of 415 leukaphereses in 201 patients stimulated with growth factor (GF; n ¼ 119) or chemotherapy-GF (n ¼ 296) were studied to determine CD34 þ cell collection efficiency (CE). The pre-apheresis leukocyte count was 1-93 Â 10 9 /l (median 20), and peripheral blood CD34 count (PBCD34) was 1-1104/ll (median 19). The total number of CD34 þ cells collected was 4-6531 Â 10 6 (median 151); corresponding to 0.1-111.4 Â 10 6 (median 2.3) per kg. There was strong correlation between PBCD34 and the number of CD34 þ cells collected (r ¼ 0.9; Po0.0001). CE was 7-145% (median 46). On multiple regression analysis, a higher leukocyte count (Po0.0001) was the most important predictor of lower CE. CE with leukocytes o20 was 7-145% (median 53%) compared to 10-132% (median 40%) with leukocyte X20 (Po0.0001). In all, 61% of the apheresis procedures performed after chemotherapy-GF occurred when leukocytes were o20 compared to 21% of those performed after GF alone (Po0.0001). We conclude that mobilizing patients with the combination of chemotherapy and GF rather than GF alone leads to leukapheresis being performed when the leukocyte count is low -in a range that results in optimum CD34 þ cell CE. Autologous stem cells should be mobilized with chemotherapy-GF rather than GF alone whenever possible. Bone Marrow Transplantation (2005) 35, 243-246.