Granulocyte colony stimulating factor (G-CSF)
Larry H. Bernstein, MD, FCAP, Curator
LPBI
G-CSF (granulocyte colony stimulating factor)
http://www.cancerresearchuk.org/about-cancer/cancers-in-general/treatment/cancer-drugs/gcsf
G-CSF is a type of growth factor. Growth factors are proteins made in the body and some of them make the bone marrow produce blood cells. G-CSF makes the body produce white blood cells to reduce the risk of infection after some types of cancer treatment. It also makes some stem cells move from the bone marrow into the blood. Stem cells are the cells in the bone marrow from which red blood cells, white cells and platelets develop.
The full name for G-CSF is granulocyte colony stimulating factor.
There are different types, including
- Lenograstim (Granocyte)
- Filgrastim (Neupogen, Zarzio, Nivestim, Ratiograstim)
- Long acting (pegylated) filgrastim (pegfilgrastim, Neulasta) and lipegfilgrastim (Longquex)
Pegylated G-CSF stays in the body for longer so you have treatment less often than with the other types of G-CSF.
You may have G-CSF
G-CSF after chemotherapy
A common side effect of chemotherapy is a drop in the number of white blood cells, which leads to an increased risk of getting an infection. Most people’s white blood cells recover quickly after chemotherapy and they don’t need treatment with G-CSF. But with some types of chemotherapy, such as high dose treatment, it can take a long time for the number of white blood cells to rise again.
Having G-CSF treatment can make white blood cell levels go up faster. So if your white blood cell count doesn’t go up as it should you may have G-CSF treatment. With some types of chemotherapy you have G-CSF as a standard part of your treatment plan.
G-CSF before and after a stem cell transplant
You may have G-CSF as part of a stem cell transplant. Before the treatment you have G-CSF to stimulate the bone marrow to produce stem cells and release them into the blood. The stem cells are collected and then you have high dose chemotherapy.
The chemotherapy stops your bone marrow producing blood cells. So you have the stem cells back into your bloodstream. They go into the bone marrow and start making the different types of blood cells again.
You can have G-CSF either
You may have G-CSF as a drip into your bloodstream (intravenously). You can have it through a thin, short tube (a cannula) put into a vein in your arm each time you have treatment. Or you may have it through a central line, a portacath or aPICC line. These are long, plastic tubes that give the drugs directly into a large vein in your chest. You have the tube put in just before your course of treatment starts and it stays in place as long as you need it.
If you have G-CSF as an injection under the skin you have it daily for up to 14 days. You have regular blood tests to check your white blood cell count. If you are having it as part of a planned treatment you start at least a day after your chemotherapy and continue until the number of white blood cells called neutrophils is within the normal range.
If you are having pegylated G-CSF you only need to have one injection at least 24 hours after the end of the chemotherapy.
Common side effects
More than 10 in every 100 people have one or more of the side effects listed below.
- Headaches
- Loss of appetite
- Redness and irritation at the injection site
- Feeling or being sick, but this is usually well controlled with anti sickness medicines
- Bone pain happens in up to 4 out of 10 people (40%). It is caused by the bone marrow making blood cells. Paracetamol can help to control any pain
- Diarrhoea – drink plenty of fluids. Tell your doctor or nurse if diarrhoea becomes severe, or continues for more than 3 days
- Constipation – your doctor or nurse may give you laxatives to help prevent this but do tell them if you are constipated for more than 3 days
- Liver changes that are very mild and unlikely to cause symptoms – the liver will almost certainly go back to normal when the treatment ends. You will have regular blood tests to check how well your liver is working
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