Neupogen for stem cell mobilization: Dose and Duration

Neupogen(filgrastim)  is often used to drive progenitor cells into the peripheral blood so they can collected by the leukophereses for use in a stem cell transplant. It is FDA approved for this purpose.

Regarding dose, please look at the professional version. How long should Neupogen be used? It is recommended that NEUPOGEN® (filgrastim) be given for at least 4 days before the first leukapheresis procedure and continued until the last leukapheresis. The FDA says, “Although the optimal duration of NEUPOGEN® (filgrastim) administration and leukapheresis schedule have not been established‚ administration of NEUPOGEN® (filgrastim) for 6 to 7 days with leukaphereses on days 5‚ 6‚ and 7 was found to be safe and effective (see Clinical Experience for schedules used in clinical trials). Neutrophil counts should be monitored after 4 days of NEUPOGEN® (filgrastim) ‚ and NEUPOGEN® (filgrastim) dose modification should be considered for those patients who develop a WBC count > 100‚000/mm3.” In none of the studies listed in the Clinical Experience section, was Neupogen used for 14 days for stem cell mobilization.

Clinical studies have used longer administrations than the FDA recommends, for example, Ria et al, used a 12 day schedule. Nevertheless, the FDA approved dose and schedule are the most common and there is little evidence to prefer a longer schedule.

Read the Professional version here.

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