IV/SC Established cytotoxic chemotherapy 0.5 MIU (5 mcg)/kg daily SC inj. 1st dose should not be administered <24 hr following cytotoxic chemotherapy. To be continued until expected neutrophil nadir has passed & neutrophil count has recovered to the normal range. Duration of treatment: up to 14 days following chemotherapy for solid tumours, lymphomas & lymphoid leukaemia; up to 38 days following induction & consolidation treatment for AML.
Myeloablative therapy followed by bone marrow transplantation Initially, 1 MIU (10 mcg)/kg as 30-min or 24-hr IV infusion or 1 MIU (10 mcg)/kg as 24-hr continuous SC infusion. 1st dose should not be given <24 hr following cytotoxic chemotherapy & w/in 24 hr before bone marrow infusion. Dosage schedule after neutrophil nadir has been passed: Neutrophil count: >1 x 10
9/L for 3 consecutive days: reduce to 0.5 MIU/kg/day. If ANC remains >1 x 10
9/L for 3 more consecutive days: Discontinue. If ANC decreases to <1 x 10
9/L during treatment: Re-escalate dose.
Mobilisation of PBPCs in patients undergoing myelosuppressive or myeloablative therapy followed by autologous PBPC transplantation 1 MIU (10 mcg)/kg as a 24-hr continuous SC infusion or a single daily SC inj for 5-7 consecutive days. For infusion, conduct 1 or 2 leukapheresis on days 5 & 6. Recommended daily dose: PBPC mobilisation after myelosuppresive chemotherapy: 0.5 MIU (5 mcg)/kg as SC inj, from 1st day after chemotherapy completion until expected neutrophil nadir is passed & neutrophil count recovered to normal range. Perform leukapheresis when ANC rises from <0.5 x 10
9/L to >5 x 10
9/L. For patients w/o extensive chemotherapy: 1 leukapheresis.
Mobilisation of PBPCs in normal donors prior to allogeneic PBPC transplantation 10 mcg/kg/day SC for 4-5 consecutive days. Start leukapheresis at day 5, continued until day 6, if needed, in order to collect 4 x 10
6 CD34
+ cells/kg.
Congenital neutropenia Initially 1.2 MIU (12 mcg)/kg SC as a single or in divided doses.
Idiopathic or cyclic neutropenia Initially 0.5 MIU (5 mcg)/kg SC as single dose or in divided doses.
HIV Infection Reversal of neutropenia: Initially 0.1 MIU (1 mcg)/kg given daily by SC inj titrated up to max 0.4 MIU (4 mcg)/kg until normal neutrophil count is reached & can be maintained (ANC >2 x 10
9/L). Normal neutrophil count maintenance: Initial dose adjustment to alternate day dosing w/ 30 MIU (300 mcg)/day SC inj.