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When a
person has received a very high dose of radiation, destruction of the
bone marrow, potentially resulting in uncontrolled bleeding and infection,
is a major concern. To help the recovery of the bone marrow, growth
factors that stimulate the blood cells to multiply can be used. Filgrastim
(trade name Neupogen®), is a drug that was approved for
use by the FDA in 1991 for cancer patients with bone marrow damage due
to chemotherapy or radiotherapy. Treated patients have had fewer infections,
less need for intravenous antibiotics, and shortened hospital stays than
those who did not receive the drug. Neupogen may also be useful for patients
who have bone marrow damage from accidental exposures to high doses of
radiation and it is expected to provide similar benefits.
What Neupogen Is
Filgrastim
(trade name Neupogen®) is a human granulocyte colony
stimulating factor (G-CSF) produced by recombinant DNA technology. It
is a specific type of cytokine that stimulates the growth of white blood
cells.
What Cytokines
Are
Cytokines
are hormone-like proteins that act as communicators between cells.
They can relay messages between cells, telling them to grow, stop growing,
move to a trouble spot, or otherwise change the cell's function. Neupogen® is
a specific type of cytokine that stimulates the growth of white blood
cells.
Use
of Neupogen® Treat
Persons Accidentally Exposed to High Doses of Radiation
Just like
a cancer patient who has received chemotherapy or radiation therapy,
a person who has received a high dose of radiation may experience bone
marrow destruction, possibly resulting in uncontrolled bleeding and
infection. Since Neupogen® has been used successfully for cancer
patients to stimulate the growth of the white blood cells, making them
less vulnerable to infections, it is expected to help patients who have
bone marrow damage from very high doses of radiation in much the same
way.
How
Neupogen® Works
Patients
who receive very high doses of radiation often are left with very few
white blood cells. The patients' own bone marrow will eventually create
new blood cells, but this is a slow process. And until the white blood
cell counts rise sufficiently, the patients are at a high risk of death
from infection. Neupogen® can speed up the process of white
blood cell creation, reducing the time that the patient is vulnerable
to infection.
Who Can Take
Neupogen
People
may be prescribed Neupogen® following chemotherapy or radiation
therapy to assist in their recovery. Also, people may be prescribed Neupogen® following
a high dose of radiation from a radiation emergency.
Neupogen® is
safe for most adults, but should not be taken by
people who have known hypersensitivity to E. coli-derived proteins,
filgrastim, or any component of filgrastim. Children and pregnant women
should take Neupogen® with caution. It is not known if Neupogen® is
excreted in human milk, so breastfeeding women should take Neupogen with
caution as well.
Side Effects
of Neupogen®
The possible
side effects of Neupogen® include fever, diarrhea,
skin rash and weakness. The most common side effect is mild to moderate
bone pain.
How Neupogen® Is
Given
Neupogen® is
given by injection under the skin or through intravenous infusion.
What the
Treatment Plan Is
The treatment
plan is to give 5 micrograms per kilogram of patient weight (mcg/kg)
of G-CSF filgrastim (Neupogen®) daily for up to 2 weeks,
either by injection or intravenous infusion.
Where You Can Get More Information
More detailed information on cytokines can be found at the FDA web site,
at:
http://www.fda.gov/bbs/topics/CONSUMER/CON0291f.html
More detailed
information on Neupogen® can be found at:
http://www.accessdata.fda.gov/scripts/cder/onctools/labels.cfm?GN=Filgrastim
You can also call the CDC Public Response line at 1-800-311-3435 or
visit the web site at http://www.cdc.gov/netinfo.htm to
request more information.
The
Centers for Disease Control and Prevention (CDC) protects people's
health and safety by preventing and controlling diseases and injuries;
enhances health decisions by providing credible information on critical
health issues; and promotes healthy living.
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