Indications
Lenograstim is a man-made version of granulocyte colony-stimulating factor (G-CSF), a natural growth factor for white blood cells. It is used to shorten the time that neutrophils (infection-fighting white blood cells) stay low after chemotherapy, and so reduce the risk of serious infection; to speed up white cell recovery after a bone marrow or stem cell transplant; and to move stem cells from the bone marrow into the blood so they can be collected for transplant, in patients and in healthy donors.
How It Works
Lenograstim attaches to receptors on cells in the bone marrow and signals them to grow and mature into neutrophils, and to release them into the blood. It also releases blood-forming stem cells into the circulation, where they can be collected. Its structure closely matches the body’s own G-CSF, including sugar chains (glycosylation).
Dosage and Administration
Lenograstim is given as an injection under the skin or as an infusion into a vein. Treatment is started and supervised by a specialist, and the dose is calculated from body surface area or weight and the reason for use, given exactly as prescribed. It is usually started at least 24 hours after chemotherapy and continued daily until the white cell count recovers. Patients may be trained to inject at home.
Interactions
It should not be given from 24 hours before to 24 hours after chemotherapy, because fast-dividing marrow cells are more sensitive to chemotherapy. Lithium may increase the release of neutrophils. Tell the doctor about all other medicines.
Contraindications
- Allergy to Lenograstim or any ingredient
- Certain myeloid blood cancers (such as chronic myeloid leukaemia or myelodysplastic syndromes), or use to boost chemotherapy dose beyond established regimens, unless a specialist decides otherwise
Side Effects
Common effects include bone and back pain, headache, tiredness, fever, injection site reactions, raised liver enzymes and a drop in platelets. Rare but serious effects include enlargement or rupture of the spleen, lung problems (cough, breathlessness, lung inflammation), capillary leak syndrome (swelling, low blood pressure), severe allergic reactions and, in people with sickle cell disease, sickle cell crisis.
Get urgent medical help for pain in the upper left abdomen or left shoulder tip, difficulty breathing, coughing with fever, sudden swelling with dizziness or passing less urine, or signs of a severe allergic reaction.
Pregnancy and Lactation
There is limited information in pregnancy; it should be used only if the expected benefit outweighs the risk. It is not known whether it passes into breast milk, so breastfeeding is not recommended during treatment.
Precautions and Warnings
Blood counts and spleen size are checked during treatment. Use with care in people with sickle cell disease, lung problems or a history of leukaemia. Healthy donors are monitored closely and followed up long term. Tell the doctor straight away about left-sided abdominal pain.
Overdose
Overdose may cause very high white cell counts and bone pain. Treatment is stopped and supportive care given; counts usually return to normal within days.
Therapeutic Class
Haematopoietic growth factor; granulocyte colony-stimulating factor (G-CSF).
Storage
Store below 30°C, do not freeze, and keep out of the reach of children. Use the prepared solution as directed on the pack.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.