Abstract

Filgrastim (recombinant human granulocyte-colony stimulating factor) (Neupogen – Amgen-Roche) was the first of several white cell ‘colony stimulating factors’ to be licensed for use in Britain. Filgrastim stimulates specifically the production of neutrophils from progenitor cells in the bone marrow, speeds their maturation and increases their number in the peripheral blood.^1,2 Use of filgrastim is intended to reduce the duration and severity of myelosuppression that follows intensive cytotoxic chemotherapy. The manufacturer claims that filgrastim “supports full dose chemotherapy on time”, by moderating neutropenia and reducing the risk of infection that might interfere with the next cycle of treatment. When should filgrastim be given?