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Use of Granulocyte Colony-Stimulating Factors (G-CSF)

In the 1980s scientists discovered a type of protein called granulocyte-colony stimulating factor (G-CSF) that stimulates the body to make more granulocytes. It has become a standard practice to give G-CSF drugs along with certain types of chemotherapy likely to cause neutropenia. These agents can also be given as part of a bone marrow or stem cell transplant or to treat some rare conditions. Recently new forms of these agents, which are less costly, have become available; studies show them to be equivalent. The newer agents, Granix (tbo-filgrastim) and Nivestym (filgrastim-aafi) are less costly and therefore are preferred for coverage. Granix and Nivestym do not need preapproval for coverage.…

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 Should G-CSF be used to boost the immune system in patients with cancer and sepsis?

Whether a patient has cancer or not, we are trained to reach into our toolbox for whatever therapies we may have to try to alleviate a patient’s situation. In that regard, it is easy to think of granulocyte colony-stimulating factor as one such tool that can be used for a patient with a severe infection.

Articles of Interest

An Overview of the glycoprotein GM-CSF

GM-CSF is a glycoprotein and is secreted by T cells, macrophages, and mast cells in response to infection. It is a key regulator of the immune system. GM-CSF promotes the growth and differentiation of myeloid progenitor cells into neutrophils, monocytes, and dendritic cells. It also stimulates the production of other cytokines, such as IL-6 and TNF-alpha. GM-CSF gene is located on chromosome 5q31. GM-CSF was first isolated in 1977 and was approved for use in the United States in 1991.

Analysis: G-CSF Biosimilars Could Reduce Costs While Improving FN-Related Outcomes

The investigators said their analysis demonstrated both “substantial” cost savings and improved clinical outcomes from the use of biosimilar G-CSF drugs in patients undergoing myelosuppressive chemotherapy and that these findings are especially relevant to oncology practices striving to meet OCM goals.

Balancing Benefits and Risks: A Literature Review on Hypersensitivity Reactions to Human G-CSF (Granulocyte Colony-Stimulating Factor)

Human granulocyte colony-stimulating factor (G-CSF) is a granulopoietic growth factor used in the treatment of neutropenia following chemotherapy, myeloablative treatment, or healthy donors preparing for allogeneic transplantation. Few hypersensitivity reactions (HRs) have been reported, and its true prevalence is unknown.

Colony Stimulating Factors - their unique biological roles and therapeutic benefits

Colony-stimulating factors (CSFs) are secreted glycoproteins that bind to receptor proteins on the surfaces of hematopoietic stem cells, thereby activating intracellular signaling pathways that can cause the cells to proliferate and differentiate into a specific kind of blood cell, usually white blood cells. They play part in the hosts´ response to injury and infection, and although they were originally defined as haematopoietic cell growth factors, colony-stimulating factors (CSFs) have been shown to have additional unique biological functions, suggesting that they could be used to target specific conditions.

Current state and future opportunities in granulocyte colony-stimulating factor (G-CSF)

Granulocyte colony-stimulating factor (G-CSF), a protein that stimulates the growth of new blood cells, was isolated from human cells by Malcolm Moore and Karl Welte in 1984. It formed the basis for filgrastim, one of the most important drugs in cancer therapy. In the hierarchical development of hematopoiesis, G-CSF predominantly stimulates the myeloid cell series from committed progenitor cells to mature neutrophil granulocytes.

Donald Metcalf, ‘Father of CSF’ (1929–2014)

Don was most interested in G-CSF, the in vivo actions of which he correctly anticipated to be both comprehensible and highly valuable for clinical use. I recall that around that time he was pleased with and highly appreciated our discovery of human G-CSF-producing tumor in the 1970s, which provided clear evidence for the in vivo action of this cytokine. Soon after the development of its recombinant forms, lenograstim and filgrastim, respectively, in Japan and in the United States, he also manufactured filgrastim in his country, clarified molecular mechanisms of its production and action, and gained approved for clinical use in 1991, after which he initiated successful clinical trials of his own.

G-CSF and GM-CSF in Neutropenia

Few physician-scientists have made as great an impact on our understanding of hematology or improved the lives of patients, estimated more than 20 million, with blood and cancer disorders as Don Metcalf, who died in December 2014.

G-CSF in the prophylaxis and treatment of febrile neutropenia

There is clear evidence that granulocyte colony-stimulating factors (G-CSF) or granulocyte-macrophage colony-stimulating factors (GM-CSF) are able to prevent neutropenia and its associated complications as well as decrease the hospitalisation rate.

GM-CSF in inflammation

As evidenced by the latest basic research literature and clinical trial activity presented in this review, there is burgeoning interest in targeting GM-CSF in inflammatory/autoimmune disorders and for the associated pain. Obviously, determining when and where GM-CSF activity is important and, as for other mediators involved in restoring homeostasis in response to external insults, how to modulate its function without compromising its beneficial effects, will continue to be critical.

Granulocyte colony-stimulating factor for stem cell mobilisation in acute myocardial infarction: a randomised controlled trial

Although inconclusive, this is the largest trial in the field of cell-based cardiac repair after STEMI providing evidence of the tolerability and long-term safety of G-CSF treatment. The results prompt further studies to understand which patient can benefit most from BM cell mobilisation.

Granulocyte Colony-Stimulating Factor G-CSF Stimulation

Granulocyte-colony stimulating factor is also known as colony-stimulating factor 3,G-CSF, GCSF, GM-CSF or Rm-GSF.Granulocyte Colony-Stimulating Factors are a special kind of protein or “growth factor” that the body naturally manufactures in the bone marrow that is often used in cancer treatments such as chemotherapy and NK Cell Therapy.

Introducing iLite Granulocyte Colony-Stimulating Factor (G-CSF) Responsive Cell Line

Granulocyte Colony-Stimulating Factor (G-CSF) is a type of growth factor that impacts the treatment and survival of patients and is used after chemotherapy to help white blood cells recover after treatment or before and after a stem cell transplant.

Optimal use of granulocyte colony-stimulating factor prophylaxis to improve survival in cancer patients receiving treatment

FN and neutropenia-related events such as infections are relatively common complications of cytotoxic chemotherapy that can compromise the survival of cancer patients. G‑CSF prophylaxis is important in preventing FN and dose delays or reductions, as well as enabling the use of higher dose intensities of (neo)adjuvant chemotherapy that are associated with a survival benefit. All physicians treating cancer patients should consider the use of G‑CSF prophylaxis in patients receiving chemotherapy, paying particular attention to patient-related risk factors such as age > 65 years.

The complete guide to G-CSF injections

G-CSF is given to over 15,000 donors around the world every year, and it has an excellent long-term safety record. While side-effects are common, they usually pass very quickly and there are some key things you can do to help:

The Use of G-CSF In The Prevention of Febrile Neutropenia

G-CSF has been reproduced by recombinant DNA technology and is believed to have similar activity to that of endogenous G-CSF. Clinically, it has been shown to reduce the incidence2,4,5 and duration2 of febrile neutropenia. It has been used for many indications, but most frequently in the prevention of febrile neutropenia following myelosuppressive chemotherapy, including both primary and secondary prophylaxis*. However, there are no studies available to date demonstrating that G-CSF improves the response to chemotherapy or affects overall survival.

Resources

4 Clinical Pearls for Granulocyte Colony Stimulating Factors (G-CSFs)

Overall, G-CSFs are well tolerated. Although rare, there are a few serious adverse effects to monitor for. Patients must be monitored for splenic rupture. .. There are 6 formulations of G-CSF at the time of this writing (including 2 biosimilars). Here's a quick breakdown of the dosing for each. filgrastim [Neupogen]: 5 - 10 mcg/kg/day daily SubQ or IV. filgrastim-sndz [Zarxio]: a biosimilar product for Neupogen. Also dosed at 5 - 10 mcg/kg/day daily SubQ or IV. tbo-filgrastim [Granix]: another biosimilar for Neupogen. Also dosed at 5 - 10 mcg/kg/day daily SubQ or IV. pegfilgrastim [Neulasta], [Neulasta Onpro]: 6 mg SubQ once per cycle of myelosuppressive chemotherapy. sargramostim [Leukine]: 250 mcg/m2/day daily SubQ or IV. Leukine is actually a GM-CSF (it stimulates both granulocytes and macrophages). It's primarily used in the setting of stem cell/bone marrow transplants, although it also has an indication for AML.