II. Indications

  1. Myelosuppressive Chemotherapy-Induced Neutropenia
  2. Bone Marrow Transplant
  3. Peripheral blood progenitor cell collection (donor)
  4. Severe chronic congenital Neutropenia (or other chronic Neutropenia)
  5. Acute Radiation Syndrome related myelosuppression

III. Mechanism

  1. Granulocyte Colony-Stimulating Factor (G-CSF)
    1. Endogenous Cytokine that modulates the production, differentiation and function Neutrophilic Granulocyte progenitors
    2. G-CSF is endogenously produced by Monocytes, fibroblasts, and endothelial cells
    3. G-CSF activates Granulocyte production via binding specific cell surface receptors
  2. Filgrastim
    1. Recombinant, synthetic agent that is nearly identical to the B isoform of G-CSF
    2. Like G-CSF, Filgrastim stimulates the production of Neutrophils
    3. Used to counter Neutropenia secondary to anticancer drug induced myelosuppression

IV. Precautions

  1. Do NOT give within 24 hours of cytotoxic/myelosuppressive Chemotherapy
    1. Unknown risk of cytotoxic agents on rapidly dividing myeloid cells
  2. Storage
    1. Store medication in refrigerator
    2. Use within 24 hours when at room Temperature

V. Dosing: Adults and Children

  1. See other references for specific dosing
  2. Myelosuppressive Chemotherapy-Induced Neutropenia
    1. Start 5 mcg/kg/day SQ or IV until postnadir ANC>10,000/mm3 (or otherwise considered recovered)
  3. Bone Marrow Transplant
    1. Start 10 mcg/kg/day IV infused over 4 to 24 hours, given >24 hours after cytotoxic Chemotherapy or marrow
  4. Peripheral blood progenitor cell collection (donor)
    1. Give 10 mcg/kg/day SQ for at least 4 days (up to 6 to 7 days) before first leukapheresis and until final leukapheresis
    2. Decrease dose if White Blood Cell Count >100,000/mm3
  5. Severe chronic congenital Neutropenia (or other chronic Neutropenia)
    1. Start 5 mcg/kg SQ daily
    2. Some protocols start 6 mcg/kg SQ twice daily
  6. Acute Radiation Syndrome related myelosuppression
    1. Start 10 mcg/kg SQ daily

VI. Adverse Effects

  1. Medullary bone pain
  2. Allergic Reaction
  3. Cutaneous Vasculitis

VII. Safety

  1. Unknown safety in pregnancy
  2. Unknown safety in Lactation

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Related Studies

Ontology: Granulocyte Colony-Stimulating Factor (C0079459)

Definition (NCI) Colony Stimulating Factor 3, encoded by the CSF3 gene, is a cytokine that controls the production, differentiation, and function of granulocytes. The active protein is found extracellularly. Three transcript variants encoding three different protein isoforms have been found for this gene. (From LocusLink)
Definition (NCI_NCI-GLOSS) A colony-stimulating factor that stimulates the production of neutrophils (a type of white blood cell). It is a cytokine that is a type of hematopoietic (blood-forming) agent.
Definition (MSH) A glycoprotein of MW 25 kDa containing internal disulfide bonds. It induces the survival, proliferation, and differentiation of neutrophilic granulocyte precursor cells and functionally activates mature blood neutrophils. Among the family of colony-stimulating factors, G-CSF is the most potent inducer of terminal differentiation to granulocytes and macrophages of leukemic myeloid cell lines.
Concepts Amino Acid, Peptide, or Protein (T116) , Immunologic Factor (T129)
MSH D016179
SnomedCT 80572003
LNC LP89646-1, MTHU031847
English G-CSF, Granulocyte Colony-Stimulating Factor, Colony-stimulating factor, granulocyte, granulocyte colony stimulating factor, GCSF, GRANULOCYTE COLONY A STIMULATING FACTOR, Colony-Stimulating Factor (Granulocyte), GCSF (granulocyte colony stimulating factor), Granulocyte Colony-Stimulating Factor [Chemical/Ingredient], csf g, g-csf, g csf, gcsf, CSF-G, Colony-stimulating factor, granulocytic, Colony-stimulating factor, granulocytic (substance), granulocyte colony-stimulating factor, G CSF, Pluripoietin, Colony Stimulating Factor 3, Granulocyte Colony Stimulating Factor, CSF3, Granulocyte colony stimulating factor
Swedish Granulocytkolonistimulerande faktor
Spanish CSF - G, factor estimulante de formación de colonias, granulocítica (sustancia), Factor Estimulante de Colonias de Granulocitos, factor estimulante de formación de colonias, granulocítica, factor estimulante de colonias granulocíticas (sustancia), factor estimulante de colonias granulocíticas, G-CSF
Czech faktor stimulující kolonie granulocytů, granulocyty stimulující faktor
Finnish Granulosyyttipesäkkeitä stimuloiva kasvutekijä
French Facteur stimulant les colonies de granulocytes, Facteur de croissance des colonies granulocytaires, Facteur stimulant la formation de colonies de granulocytes neutrophiles, Facteur de croissance granulocytaire, Facteur stimulant la formation de colonies de neutrophiles, Facteur de stimulation des colonies de granulocytes, Facteur de croissance des granulocytes, G-CSF, GCSF
Russian GRANULOTSITOV KOLONIESTIMULIRUIUSHCHII FAKTOR, G-KSF, KOLONIESTIMULIRUIUSHCHII FAKTOR GRANULOTSITOV, Г-КСФ РЕКОМБИНАНТНЫЙ МЕТИОНИЛ ЧЕЛОВЕКА, ГРАНУЛОЦИТОВ КОЛОНИЕСТИМУЛИРУЮЩИЙ ФАКТОР РЕКОМБИНАНТНЫЙ, FILGRASTIM, G-KSF REKOMBINANTNYI, REKOMBINANTNOGO METIONILA GRANULOTSITOV CHELOVEKA KOLONIESTIMULIRUIUSHCHII FAK, ФИЛГРАСТИМ, G-KSF REKOMBINANTNYI METIONIL CHELOVEKA, РЕКОМБИНАНТНЫЙ КОЛОНИЕСТИМУЛИРУЮЩИЙ ФАКТОР ГРАНУЛОЦИТОВ, Г-КСФ РЕКОМБИНАНТНЫЙ, РЕКОМБИНАНТНЫЙ G-CSF, GRANULOTSITOV KOLONIESTIMULIRUIUSHCHII FAKTOR REKOMBINANTNYI, REKOMBINANTNYI G-CSF, REKOMBINANTNYI KOLONIESTIMULIRUIUSHCHII FAKTOR GRANULOTSITOV, РЕКОМБИНАНТНОГО МЕТИОНИЛА ГРАНУЛОЦИТОВ ЧЕЛОВЕКА КОЛОНИЕСТИМУЛИРУЮЩИЙ ФАК, G-CSF, Г-КСФ, ГРАНУЛОЦИТОВ КОЛОНИЕСТИМУЛИРУЮЩИЙ ФАКТОР, КОЛОНИЕСТИМУЛИРУЮЩИЙ ФАКТОР ГРАНУЛОЦИТОВ
Italian G-CSF, Fattore stimolante le colonie dei granulociti
German GRANULOZYTEN KOLONIE A STIMULIERENDER FAKTOR, G-CSF, Granulozyten-Kolonien-stimulierender Faktor
Portuguese G-CSF, Fator Estimulador de Colônias de Granulócitos
Croatian GRANULOCITNA KOLONIJA, STIMULIRAJUĆI FAKTOR
Polish Czynnik stymulujący kolonie granulocytów, G-CSF, Filgrastim, Czynnik stymulujący kolonie granulocytów rekombinowany
Japanese 顆粒球コロニー活性化因子, 顆粒球コロニー刺激因子, 顆粒球コロニー形成刺激因子, 顆粒球コロニー形成活性化因子

Ontology: Filgrastim (C0210630)

Definition (NCI_NCI-GLOSS) A colony-stimulating factor that stimulates the production of neutrophils (a type of white blood cell). It is a cytokine that is a type of hematopoietic (blood-forming) agent.
Definition (NCI) A recombinant, non-glycosylated cytokine which is chemically identical to or similar to the endogenous cytokine human granulocyte colony-stimulating factor (G-CSF) isoform B, with immunomodulating activity. Filgrastim binds to and activates G-CSF receptors with the same biological activity and stability as the endogenous cytokine, thereby controlling the production, differentiation, and function of neutrophilic granulocyte progenitors.
Definition (PDQ) A recombinant therapeutic agent which is chemically identical to or similar to the endogenous cytokine human granulocyte colony-stimulating factor (G-CSF). Produced endogenously by monocytes, fibroblasts, and endothelial cells, G-CSF binds to and activates specific cell surface receptors, stimulating neutrophil progenitor proliferation and differentiation and selected neutrophil functions. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=41057&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=41057&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C1474" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116) , Immunologic Factor (T129)
MSH D019376 , C554038
SnomedCT 108965009, 386948008
English filgrastim, G-CSF - Recombinant human, G-CSF - Recombinant human granulocyte-colony, Recombinant Methionyl Human Granulocyte Colony Stimulating Factor, Recombinant-Methionyl Human Granulocyte Colony Stimulating Factor, G-CSF, filgrastrim, FILGRASTIM, filgrastim (medication), Filgrastim [Chemical/Ingredient], r-methug-csf, r-metHuG-CSF, Recombinant-Methionyl Human Granulocyte Colony-Stimulating Factor, G-CSF Recombinant, Human Methionyl, Tbo-filgrastim, Filgrastim XM02, rG-CSF, G-CSF - Recombinant human granulocyte-colony stimulating factor, Filgrastim (product), Filgrastim (substance), Filgrastim
Swedish Filgrastim
Finnish Filgrastiimi
Japanese 組換えメチオニルヒト顆粒状コロニー刺激因子, 組換えG-CSF-ヒトメチオニル, ヒトメチオニル組換えG-CSF, 組換えメチオニルヒト顆粒球コロニー刺激因子, 顆粒球コロニー刺激因子-組換えメチオニルヒト, フィルグラスチム
Spanish filgrastima (producto), filgrastima, filgrastim, filgrastim (sustancia), filgrastim (producto), filgrastima (sustancia)