Lenograstrim
Indications
Lenograstrim is used for:
Neutropenia, Reduce the risk of life-threatening infection in patients with neutropenia after cytotoxic chemotherapy.
Adult Dose
Intravenous
Neutropenia following bone marrow transplantation
Adult: 19.2 million IU/m2 or 150 mcg/m2 daily by IV infusion started the day after transplantation for a maximum of 28 consecutive days.
Subcutaneous
Mobilisation of peripheral blood progenitor cells for autologous peripheral blood stem cell transplantation
Adult: As monotherapy: 1.28 million IU/kg or 10 mcg/kg daily for 4-6 days (5-6 days in healthy donors). Following adjunctive myelosuppressive chemotherapy: 19.2 million IU/m2 or 150 mcg/m2 daily, started the day after completion of chemotherapy for a maximum of 28 consecutive days.
Chemotherapy-induced neutropenia
Adult: 19.2 million IU/m2 or 150 mcg/m2 daily, start the day after completion of chemotherapy for a maximum of 28 consecutive days.
Child Dose
Intravenous
Neutropenia following bone marrow transplantation
Child: >2 yr: 19.2 million IU/m2 or 150 mcg/m2 daily by IV infusion started the day after transplantation for a maximum of 28 consecutive days.
Renal Dose
Administration
Contra Indications
Contraindicated in patients with bone marrow cancer, children less than 2 years, and hypersensitivity.
Precautions
Premalignant or malignant myeloid condition; sickle-cell disease; osteoporotic bone disease; signs of pulmonary infiltrates (withdraw treatment). Monitor CBC during therapy. Pregnancy and lactation.
Pregnancy-Lactation
Interactions
Increased risk of myelosuppression with myelosuppressive antineoplastic agents; increased pulmonary toxicity with bleomycin and cyclophosphamide.
Adverse Effects
Side effects of Lenograstrim :
Musculoskeletal - Musculoskeletal pain, bone pain, splenic enlargement and osteoporosis.
Gastrointestinal - Nausea, diarrhea and loss of appetite.
Blood - Anemia and decrease in platelet counts.
Skin - Painful skin condition, skin death and skin inflammation.
Miscellaneous - Fever, headache and painful urination.
Mechanism of Action
Lenograstrim (rHuG-CSF) belongs to the cytokine group of biologically active proteins which regulate cell differentiation and cell growth. rHuG-CSF is a factor which stimulates the neutrophil precursor cells as demonstrated by the CFU-S and CFU-GM cell count increases in peripheral blood.