II. Indications
- Myelosuppressive Chemotherapy-Induced Neutropenia
- Acute Radiation Syndrome related myelosuppression
III. Mechanism
- Granulocyte Colony-Stimulating Factor (G-CSF)
- Endogenous Cytokine that modulates the production, differentiation and function Neutrophilic Granulocyte progenitors
- G-CSF is endogenously produced by Monocytes, fibroblasts, and endothelial cells
- G-CSF activates Granulocyte production via binding specific cell surface receptors
- Pegfilgrastim
- Pegfilgrastim is a recombinant, synthetic agent similar to the B isoform of G-CSF
- Like G-CSF, Pegfilgrastim stimulates the production of Neutrophils
- Used to counter Neutropenia secondary to anticancer drug induced myelosuppression
- Pegfilgrastim is the pegylated (conjugated to Polyethylene Glycol) form of Filgrastim
- Pegylation significantly increases the Half-Life of Filgrastim
- Pegfilgrastim is a recombinant, synthetic agent similar to the B isoform of G-CSF
IV. Precautions
- Do NOT give 14 days before or 24 hours after cytotoxic/myelosuppressive Chemotherapy
- Unknown risk of cytotoxic agents on rapidly dividing myeloid cells
- Storage
- Store medication in refrigerator
- Use within 48 hours when at room Temperature
- Protect from light exposure
V. Dosing: Adult
- See other references for specific dosing
- Myelosuppressive Chemotherapy-Induced Neutropenia
- Give 6 mg SQ once per Chemotherapy cycle
-
Acute Radiation Syndrome related myelosuppression
- Give 6 mg SQ for 2 doses, 1 week apart
VI. Dosing: Child
- Weight-Based Dosing
- Weight <10 kg: 0.1 mg/kg
- Weight 10 to 20 kg: 1.5 mg
- Weight 21 to 30 kg: 2.5 mg
- Weight 31 to 44 kg: 4.0 mg
- Weight >=45 kg: Use adult dosing as above
- Myelosuppressive Chemotherapy-Induced Neutropenia
- Give weight-based dose SQ once per Chemotherapy cycle
-
Acute Radiation Syndrome related myelosuppression
- Give weight-based dose SQ for 2 doses, 1 week apart
VII. Adverse Effects
- Medullary bone pain
- Allergic Reaction
- Cutaneous Vasculitis
VIII. Safety
- Unknown safety in pregnancy
- Unknown safety in Lactation
IX. Resources
- Pegfilgrastim (DailyMed)