Recombinant human G-CSF

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5E. HEMATINICS/HEMATOPOIETICS in 5. HEMATOLOGICAL SYSTEM
RECOMBINANT HUMAN G-CSF
G-CSF | HEMATOPOIETIC STIMULATOR
PK: A: 100%(SC) D: 150 mL/kg(Vd)

Indications & Dose: BONE MARROW TRANSPLANTATION SC Adult Initially 10µg/kg/day as inf over 30min or given as continuous IV/SC inf over 24h after transplantation, dose adjusted according to response | CHEMOTHERAPY-INDUCED NEUTROPENIA IV/SC Adult 5µg/kg/day, dose may be increased by 5µg/kg (for each chemotherapy cycle) according to the duration & severity of the neutropenia, continue for 2 wk or until ANC reaches 10, 000/mm3 Child Same as adult dose | NEONATAL NEUTROPENIA SC Child 10µg/kg/day, discontinue if WBC >500 million/L | NEUTROPENIA Chronic/Severe SC Adult Congenital 6µg/kg BID, idiopathic/cyclic 5µg/kg/day, adjust the dose based on ANC & clinical response Child 1 month–18 yr: Congenital 12µg/kg/day in single/divided doses, idiopathic/cyclic 5µg/kg/day, adjusted according to response | PERIPHERAL BLOOD PROGENITOR CELL COLLECTION SC Adult 10µg/kg/day for 6-7 days, initiated at least 4 days before the first leukapheresis & continue until the last leukapheresis. Dosage adjustment may be required for WBC >100, 000/mm3 Child Same as adult dose | PERSISTENT NEUTROPENIA IN HIV INFECT SC Adult Initially 1µg/kg/day max 4µg/kg/day until absolute neutrophil count in normal range, MD 300µg/day on 1-7 days a wk Child 1 month-18 yr: Initially 1µg/kg/day, increased as necessary until absolute neutrophil count in normal range max 4µg/kg/day | TO REDUCE THE INCIDENCE OF NEUTROPENIA ASSOCIATED WITH ANTINEOPLASTIC THERAPY SC Adult > 45kg: 6mg as single dose, given not less than 24hrs after the last dose of antineoplastic

Contra: Hypersensitivity, severe congenital neutropenia with abnormal cytogenetics, myeloid malignancies

Precautions: Sickle-cell disease, secondary acute myeloid leukemia, 24h before until 24h after cytotoxic chemotherapy, osteoporotic bone disease, patients with pre-malignant/malignant myeloid condition

ADR: Serious: MI, hypotension, HTN, arrhythmias, bleeding, sickle cell crisis, thrombocytopenia, splenic ruptures, cutaneous necrotic vasculitis, leukocytosis, transient SV tachycardia, hyperuricemia, hypersensitivity reactions, Others: Headache, weakness, chest pain, nausea, vomiting, diarrhea, constipation, abdominal pain, stomatitis, dyspnea, cough, pruritus, rash, erythema, alopecia, pain at Inj site, fever

DDI: Serious Cyclophosphamide increases occurrence of pulmonary toxicity, Anti-neoplastics increases risk of myelosuppression

Monitor: CBC, platelets , bone marrow and karyotype prior to treatment, bone marrow and cytogenetics annually throughout treatment, temperature

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