Lenograstim
Mechanism :
Colony-stimulating factors are glycoproteins which act on hematopoietic cells by binding to specific cell surface receptors and stimulating proliferation, differentiation commitment, and some end-cell functional activation.
Indication :
- To increase neutrophil count in following conditions
- Peripheral Blood Progenitor Cell Collection
- Myelosuppressive Chemotherapy Treatment
- Acute myeloid leukemia receiving induction or consolidation chemotherapy
- Cancer patients receiving bone marrow transplant
- Severe chronic neutropenia
Contraindications :
Contraindicated in patients with known hypersensitivity to E coli-derived proteins or any component of the product. Caution in tumours with myeloid characteristics. Monitoring of bone density may be required in patients with underlying osteoporotic bone disease.
Dosing :
Pediatric Dose for Neutropenia Associated with Chemotherapy:
Initial dose: 5 mcg/kg/day as a single daily SC bolus injection, or short intravenous infusion (15 to 30 minutes) or by continuous subcutaneous or intravenous infusion.
Maintenance dose: 4 to 8 mcg/kg/day.
Duration of therapy: Up to 2 weeks, until the absolute neutrophil count reaches 10,000/mm³.
Congenital Neutropenia:
Initial dose: 6 mcg/kg subcutaneously twice a day.
Median dose: 6.0 mcg/kg/day.
Idiopathic or Cyclic Neutropenia:
Initial dose: 5 mcg/kg subcutaneously once a day.
Cyclic neutropenia:
Median dose: 2.1 mcg/kg/day.
Idiopathic neutropenia:
Median dose: 1.2 mcg/kg/day.
Adverse Effect :
Mild-to-moderately severe medullary bone pain, nausea, vomiting, hair loss, bone pain, peritonitis, fatigue, fever, and diarrhea, headache, shortness of breath, weight loss, mouth sores, rash, heart attacks, abnormal heart rhythm. Uric acid, lactate dehydrogenase, and alkaline phosphatase levels may rise and spontaneously return to normal levels.
Interaction :
Lithium: Drugs which may potentiate the release of neutrophils, such as lithium, should be used with caution.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function |
| 10-20 | Dose as in normal renal function |
| <10 | Dose as in normal renal function |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Not dialysed. Dose as in normal renal function |
| HD | Not dialysed. Dose as in normal renal function |
| HDF/High flux | Unlikely to be dialysed. Dose as in normal renal function |
| CAV/VVHD | Not dialysed. Dose as in normal renal function |
Hepatic Dose :
In patients with severe hepatic impairment, the safety and efficacy has not been established.