Filgrastim and Bone Marrow Transplantation
During bone marrow transplantation, very strong chemotherapy is given that destroys the bone marrow, also destroying the body's ability to make neutrophils. This puts the body at a very high risk for infection. New bone marrow (either from a donor or the person's own bone marrow previously collected) is transplanted and will begin to produce neutrophils to protect from infection. However, it takes awhile for the bone marrow to begin functioning, and during this time, there is a very large risk of infection.
Filgrastim increases the neutrophil production, protecting the body from infection.
Bone marrow transplantations can be used in the treatment of a wide variety of cancers. Filgrastim should not be used during bone marrow transplantation in people with myeloid cancers, as filgrastim may potentially make these cancers worse.
Filgrastim and Stem Cell Collection
As an alterative to collecting bone marrow for transplantation, stem cells may be collected from the blood. These stem cells can then be transplanted. This is known as peripheral blood stem cell transplantation (PBSCT). Unlike bone marrow collection, stem cell collection from the blood does not require general anesthesia. Giving filgrastim before collecting stem cells can stimulate the release of more stem cells in the blood, making the collection and transplantation more successful.
Filgrastim and Severe Chronic Neutropenia
Some people are born with a decreased ability to produce neutrophils and are very susceptible to dangerous infections. This type of severe chronic neutropenia is known as congenital neutropenia. Some people are born with a condition called cyclic neutropenia that causes low neutrophils to come and go regularly. Another type is idiopathic severe chronic neutropenia, which is any neutropenia that occurs for unknown reasons.
Filgrastim is approved to treat severe chronic neutropenia to reduce the occurrence and severity of problems due to low neutrophils, including infections, fevers, and mouth and throat sores.