It is indicated as a treatment to reduce the duration of neutropenia and the severity of infections in patients with non-myeloid malignancy who have undergone autologous or allogeneic bone marrow transplantation, or treatment with established cytotoxic chemotherapy and in addition to reduce the incidence of infection associated with established cytotoxic chemotherapy. ?It is also indicated to mobilise peripheral blood progenitor cells (PBPCs) with it alone, or after myelosuppressive chemotherapy, in order to accelerate haematopoietic recovery by infusion of such cells, after myelosuppressive or myeloablative therapy. It is also indicated to accelerate the engraftment of these cells after their reinfusion. ? It is also indicated for the treatment of severe chronic neutropenia including congenital agranulocytosis (Kostmann's syndrome).
Lenograstim is the glycosylated recombinant form of human granulocyte colony stimulating factor. Lenograstim accelerates neutrophil recovery significantly after chemotherapy, with beneficial effects on clinical end-points such as incidence of laboratory-confirmed infection and length of hospital stay. Chemotherapy dose intensity has also been increased in patients receiving lenograstim, notably those with breast or small cell lung cancer, although improvements in tumour response and survival have not been demonstrated. Lenograstim also assists neutrophil recovery in patients undergoing bone marrow transplantation, and stimulates the production of peripheral blood stem cells (PBSCs) for autologous transfusion after aggressive chemotherapy.
Intravenous- Neutropenia following bone marrow transplantation: Adult: 19.2 million IU/m2 or 150 mcg/m2 daily by IV infusion started the day after transplantation for a maximum of 28 consecutive days. Child: >2 yr: 19.2 million IU/m2 or 150 mcg/m2 daily by IV infusion started the day after transplantation for a maximum of 28 consecutive days. Subcutaneous- Mobilisation of peripheral blood progenitor cells for autologous peripheral blood stem cell transplantation: Adult: As monotherapy: 1.28 million IU/kg or 10 mcg/kg daily for 4-6 days (5-6 days in healthy donors). Following adjunctive myelosuppressive chemotherapy: 19.2 million IU/m2 or 150 mcg/m2 daily, started the day after completion of chemotherapy for a maximum of 28 consecutive days. Subcutaneous- Chemotherapy-induced neutropenia: Adult: 19.2 million IU/m2 or 150 mcg/m2 daily, start the day after completion of chemotherapy for a maximum of 28 consecutive days.
Increased risk of myelosuppression with myelosuppressive antineoplastic agents; increased pulmonary toxicity with bleomycin and cyclophosphamide.
it should not be administered to patients with known hypersensitivity to the product or its constituents. it should not be used to increase the dose intensity of cytotoxic chemotherapy beyond established dosage regimens and time courses since the drug could reduce myelotoxicity but not overall toxicity of cytotoxic drugs. it should not be administered concurrently with cytotoxic chemotherapy. it should not be administered to patients suffering from myeloid malignancy.
Bone pain, splenic enlargement, nausea, fever, thrombocytopenia, anaemia, epistaxis, headache, diarrhoea, dysuria, osteoporosis, cutaneous vasculitis, anorexia, Sweet's syndrome
Use during Pregnancy, Delivery or Lactation It is advised not to administer to pregnant women or women having possibilities of being pregnant. [The safety of this product has not yet been established in pregnant women.]
Should be stored in cool and dry place
Lenograstim (rHuG-CSF) 13.4 million International Units (equivalent to 105 micrograms) per ml after reconstitution
Lenograstim (rHuG-CSF) 33.6 million International Units (equivalent to 263 micrograms) per ml after reconstitution
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