Filgrastim

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
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

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

See other references for specific dosing
Myelosuppressive Chemotherapy-Induced Neutropenia
1. Start 5 mcg/kg/day SQ or IV until postnadir ANC>10,000/mm3 (or otherwise considered recovered)
Bone Marrow Transplant
1. Start 10 mcg/kg/day IV infused over 4 to 24 hours, given >24 hours after cytotoxic Chemotherapy or marrow
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
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
Acute Radiation Syndrome related myelosuppression
1. Start 10 mcg/kg SQ daily