Filgrastrim is used for: (DNB June 2012)
a. Filgrastrim is recombinant human G-CSF (rHuG-CSE used to mitigate the adverse effects of anticancer drugs.
b. It is a nonglycosylated peptide of 175 aminoacids.
c. rHuGM-CSF has also been developed → called Sargramostim.
d. Sargramostim is partly glycosylated peptide of amino acids.
e. Pegfilgrastrim (Pegylated filgrastrim) has much longer half life than filgrastrim and can be used once per chemotherapy cycle.
a. Myeloid growth factors stimulate proliferation and differentiation of myeloid progenitor cells
b. Action mediated via JAK/STAT pathway
c. GM-CSF has broader biological actions than G-CSF. It affects early & late granulocytic progenitor cells, erythroid and megakaryocytic progenitors.
d. 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.
f. G-CSF is better tolerated
g. G-CSF can cause bone pain (reversible on discontinuation)
h. GM-CSF can lead to - fever, malaise, arthralgias, myalgias and a capillary leak syndrome (characterized by pleural/pericardial effusions and peripheral edema.
i. Splenic rupture occurs rarely with G-CSF.