Filgrastrim is used for: (LQ)
- Filgrastrim is recombinant human G-CSF (rHuG-CSE used to mitigate the adverse effects of anticancer drugs.
→ It is a nonglycosylated peptide of 175 aminoacids.
- rHuGM-CSF has also been developed → called sargramostim.
- Sargramostim is partly glycosylated peptide of amino acids.
- Pegfilgrastrim (Pegylated filgrastrim) has much longer half-life than filgrastrim and can be used once per chemotherapy cycle.
- Myeloid growth factors stimulate proliferation and differentiation of myeloid progenitor cells
- Action mediated via JAK/ST A T pathway
- GM-CSF has broader biological actions than G
- CSF. It affects early & late granulocytic progenitor cells, erythroid and megakaryocytic progenitors.
- GM-CSF also stimulates T cell proliferation (together with IL-2) and causes mobilization of peripheral blood stem cells (this property has therapeutic significance) G-CSF>GM-CSF.
a. G-CSF is better tolerated
b. G-CSF can cause bone pain (reversible on discontinuation)
c. GMCSF can lead to - fever, malaise, arthralgias, myalgias and a capillary leak syndrome (characterized by pleural/pericardial effusions and peripheral edema.
d. Splenic rupture occurs rarely with G-CSF.