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Myeloid Growth Factors
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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
What is secondary prophylaxis of neutropenia?
use of CSF to prevent
recurrent
neutropenia
What is treatment of neutropenia?
use of CSF as part of the tx of febrile neutropenia
NOT recommended - no real improvement is seen
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
What are the options for someone who developed neutropenia in a previous stage of chemo?
decrease dose
increase interval
start secondary prophylaxis
What are the CSFs used in prophylaxis of neutropenia?
Filgrastim
Pegfilgrastim
Sargramostim
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)
Which CSF has the longers half-life?
Pegfilgrastim = 15-80hrs (others are ~3hrs)
What is the dose of Filgrastim for prophylaxis of neutropenia?
5 mcg/kg/d SQ until ANC is at least 2000/mm
3
What is the dose of Pegfilgrastim for prophylaxis of neutropenia?
6 mg SQ once per cycle
What is the dose of Sargramostim for prophylaxis of neutropenia?
250 mcg/m
2
/d SQ until ANC is at least 2000/mm
3
When should CSF be initiated for prophylaxis of neutropenia?
24-72hrs after chemotherapy
if given before then, neutropenia gets worse!
What are the SE of Filgrastim and Pegfilgrastim?
Bone pain
Allergic-type rxns
Splenic rupture (rare)
ARDS
What are the SE of Sargramostim?
Fluid retention
Respiratory sx
Cardiovascular sx
Renal/hepatic dysfunction
Asthenia
Diarrhea
Rash
Author
giddyupp
ID
67191
Card Set
Myeloid Growth Factors
Description
Myeloid Growth Factors
Updated
2011-02-18T03:14:09Z
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