rhGCSF

rhGCSF stands for recombinant human granulocyte colony-stimulating factor, a hematopoietic growth factor used to stimulate the production of neutrophils. It is produced through recombinant DNA technology and exists in several forms used clinically to prevent or treat neutropenia.

Mechanism and effect: rhGCSF binds to the granulocyte colony-stimulating factor receptor on hematopoietic progenitor cells in the bone marrow, promoting their proliferation and differentiation into neutrophils. It also enhances neutrophil function and survival, reduces the duration of neutropenia after chemotherapy, and lowers infection risk. In addition, rhGCSF can mobilize CD34+ hematopoietic stem cells into peripheral blood for collection in preparation for transplantation.

Forms and examples: Filgrastim is a non-glycosylated form produced in Escherichia coli. Lenograstim is a glycosylated form produced in mammalian cells. Pegfilgrastim is a pegylated, long-acting form that remains in the body longer. These drugs are marketed under various brand names in different regions.

Indications: rhGCSF is used to reduce the incidence and duration of chemotherapy-induced neutropenia in patients with solid tumors or hematologic cancers, to accelerate neutrophil recovery after autologous or allogeneic stem cell transplantation, and to mobilize peripheral blood stem cells for transplantation. It is also used to treat severe chronic neutropenia in some patients.

Administration and dosing: dosing is typically subcutaneous, often daily during neutropenia for short courses or per cycle for chemotherapy regimens. Pegfilgrastim is usually given as a single subcutaneous injection per cycle. Dosing is generally weight-based and adjusted for pediatric patients.

Safety: common adverse effects include bone pain, headache, and injection-site reactions. Other risks include leukocytosis, splenomegaly (rarely splenic rupture), and hypersensitivity reactions. Use is contraindicated in individuals with hypersensitivity to G-CSF products or their components; caution is advised in patients with myeloid malignancies or active certain infections.