Hematopoietic Growth Factors

Oncology & Immunology

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Examples

filgrastimpegfilgrastimsargramostimepoetin alfa

Prefix / Suffix: -grastim for colony-stimulating factors; -poetin for ESAs

Physiology

Cancer therapy can suppress bone marrow, lowering neutrophils or red blood cells. Growth factors stimulate marrow recovery and reduce complications in selected patients.

Mechanism of Action

G-CSF agents stimulate neutrophil production and release. ESAs stimulate red blood cell production when appropriate.

Indications

Prevention or treatment of chemotherapy-induced neutropenia
Stem cell mobilization
Anemia in selected oncology or kidney disease settings
Reduction of infection risk in high-risk regimens

Side Effects / Adverse Effects

Bone pain
Leukocytosis
Splenic enlargement or rupture rarely
Injection-site reactions
Thrombosis and hypertension with ESAs

Contraindications

Hypersensitivity to product
Do not give filgrastim too close to cytotoxic chemotherapy timing per protocol
Uncontrolled hypertension for ESAs
Use ESAs cautiously when cure is treatment goal

Nursing Considerations

Monitor CBC with differential
Teach bone pain is common and report left upper abdominal or shoulder pain
Follow timing rules around chemotherapy
Use neutropenic precautions when counts are low
For ESAs, monitor hemoglobin and clot symptoms

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