production of red blood cells, the stimulating factors discussed below affect the
production of white blood cells and platelets.
a. Granulocyte Colony Stimulating Factor; G-CSF; Filgrastim (Neupogen).
Filgrastim stimulates the growth of white blood cells, specifically the granulocytes
(neutrophils). It is used in the treatment of neutropenia (low neutrophils) from
chemotherapy or bone marrow transplant patients. The most common complaints
associated with use are nausea, vomiting, and joint aches. Filgrastim is administered
subcutaneously 5-10 mcg/kg/day until neutrophil counts rise to normal. Filgrastim is
available as an injection without preservative; it requires refrigeration.
b. Granulocyte Macrophage Colony Stimulating Factor; GM-CSF;
Sargramostim (Leukine). Sargramostim is used to stimulate the proliferation of
granulocytes and macrophages in patients with leukemia and/or undergoing bone
marrow transplant. This agent is administered 250 mcg/m2/day via IV infusion over 2-4
hours until neutrophil recovery. The side effects are similar to filgrastim. Sargramostim
must be refrigerated.