Myeloid Growth Factors

  1. What is primary prophylaxis of neutropenia?
    • use of CSF before any occurence of neutropenia
    • given when risk of febrile neutropenia is at least 20% -OR-
    • when risk is low-moderate and pt has individual risk factors
  2. What is secondary prophylaxis of neutropenia?
    use of CSF to prevent recurrent neutropenia
  3. What is treatment of neutropenia?
    • use of CSF as part of the tx of febrile neutropenia
    • NOT recommended - no real improvement is seen
  4. What are the individual risk factors for febrile neutropenia?
    • > 65yo
    • Co-morbidities (COPD, DM, CVD, Liver disease, Renal dysfunction)
    • Presence of active infection
    • Decreased immune fx
    • Poor performance status
  5. What are the options for someone who developed neutropenia in a previous stage of chemo?
    • decrease dose
    • increase interval
    • start secondary prophylaxis
  6. What are the CSFs used in prophylaxis of neutropenia?
    • Filgrastim
    • Pegfilgrastim
    • Sargramostim
  7. What is the MOA of CSF?
    • stimulate proliferation and differentiation of hematopoietic cells in the granulocyte lineage
    • Sargramostim also has activity in the macrophage lineage (no proven benefit yet)
  8. Which CSF has the longers half-life?
    Pegfilgrastim = 15-80hrs (others are ~3hrs)
  9. What is the dose of Filgrastim for prophylaxis of neutropenia?
    5 mcg/kg/d SQ until ANC is at least 2000/mm3
  10. What is the dose of Pegfilgrastim for prophylaxis of neutropenia?
    6 mg SQ once per cycle
  11. What is the dose of Sargramostim for prophylaxis of neutropenia?
    250 mcg/m2/d SQ until ANC is at least 2000/mm3
  12. When should CSF be initiated for prophylaxis of neutropenia?
    • 24-72hrs after chemotherapy
    • if given before then, neutropenia gets worse!
  13. What are the SE of Filgrastim and Pegfilgrastim?
    • Bone pain
    • Allergic-type rxns
    • Splenic rupture (rare)
    • ARDS
  14. What are the SE of Sargramostim?
    • Fluid retention
    • Respiratory sx
    • Cardiovascular sx
    • Renal/hepatic dysfunction
    • Asthenia
    • Diarrhea
    • Rash
Card Set
Myeloid Growth Factors
Myeloid Growth Factors