Glossary of Augmentation of Host Defenses

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Colony Stimulating Factors (CSF)

Reason for use?
Accelerate recovery of neutrophils
Enhance immune function
CSF: Primary use
Critical pt.


Pt. never on chemo before but predicting neutropenia
CSF: Secondary use
Subsequent cycles chemo to decrease probability of febrile neutropenia.

Avoid dose reductions or delays of CHEMO if neutropenia occurs.
CSF: Use in Febrile Patients

Consider in pt. with declining clinical status or ANC < 100
SE: Filgrastim (Neupogen)
Bone Pain, Fever, Rash,
Inj. site rxn's
SE: Sargromastim (Leukine)
** Edema, Arthalgias, Rash, Pericarditis **

Fever, Bone pain, Lethargy
Dosage: Filgrastim
5 mcg/kg/day‚ IV/SC bolus/short IV infusion (15 to 30 minutes)‚ or by continuous SC or continuous IV infusion.

Till ANC 2-3000
Dosage: Sargromastim (Leukine)
250mcg/m2 (less SE) over 4 hrs
500mcg/m2 over 12 hrs
Dosage Neulasta (Pegfilgrastim)
6mg 1 time shot 24 after chemo
CSF: Goal to Cure
Add Growth factors to maintain dosage of chemotherapy
CSF: Goal to relieve symptoms
Reduce dosage of chemotherapy 10 -25% to decr. neutropenia but chemo now less effective.

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