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Lenograstim: Brands, Price & Uses in Bangladesh
Lenograstim is a recombinant human granulocyte colony-stimulating factor (G-CSF) used to support neutrophil recovery in specific, well-defined clinical settings.
About Lenograstim
Indications of Lenograstim
Lenograstim is a recombinant human granulocyte colony-stimulating factor (G-CSF) used to support neutrophil recovery in specific, well-defined clinical settings. It is a biologic growth factor, not an antibiotic, and does not treat infection directly.
Established, guideline-supported uses
- Chemotherapy-induced neutropenia: reduction of the duration of neutropenia and its complications (including febrile neutropenia) in patients receiving established cytotoxic chemotherapy for malignancy (excluding chronic myeloid leukaemia and myelodysplastic syndromes).
- Bone marrow transplantation: reduction of the duration of neutropenia and associated clinical sequelae in patients undergoing myeloablative therapy followed by bone marrow transplantation and considered to be at increased risk of prolonged severe neutropenia.
- Peripheral blood progenitor cell (PBPC) mobilisation: mobilisation of PBPCs into the peripheral circulation, alone or following myelosuppressive chemotherapy, to accelerate haematopoietic recovery after autologous stem cell transplantation.
- Healthy donor PBPC mobilisation: mobilisation of PBPCs in healthy allogeneic donors prior to collection, to enable subsequent allogeneic stem cell transplantation.
Lenograstim is used as directed by a haematologist or oncologist as part of a broader chemotherapy or transplant protocol; it is not a standalone treatment for cancer or infection.
Dosage & Administration of Lenograstim
Lenograstim dosing is calculated individually according to body weight or body surface area and the specific indication, and must be prescribed and supervised by a physician experienced in oncology or haematology. Treatment is generally continued daily until the expected neutrophil nadir has passed and the neutrophil count has recovered to an acceptable, stable level.
| Indication | Typical dose | Route | Timing |
|---|---|---|---|
| Cytotoxic chemotherapy-induced neutropenia | 19.2 million IU (150 micrograms)/m²/day, equivalent to about 0.64 million IU (5 micrograms)/kg/day | Subcutaneous injection | Start no earlier than 24 hours after completing chemotherapy; continue until neutrophil recovery, generally up to 28 days |
| Myeloablative therapy with bone marrow transplantation | 19.2 million IU (150 micrograms)/m²/day | Intravenous infusion (about 30 minutes) or subcutaneous injection | Start no earlier than 24 hours after bone marrow infusion; continue until neutrophil recovery, generally up to 28 days |
| PBPC mobilisation after chemotherapy | 19.2 million IU (150 micrograms)/m²/day | Subcutaneous injection | Starting 1–5 days after completing chemotherapy, continued until after the expected neutrophil nadir and count recovery |
| PBPC mobilisation with Lenograstim alone (patients or healthy donors) | 1.28 million IU (10 micrograms)/kg/day | Subcutaneous injection | For 4–6 consecutive days (patients) or 5–6 days (healthy donors), with apheresis typically performed after several days |
Dosing must not be intensified beyond the recommended range in an attempt to accelerate recovery further, as this does not improve outcomes and may increase adverse effects.
Side Effects of Lenograstim
Adverse effects of Lenograstim range from common, generally mild and manageable reactions to rare but serious events that require prompt medical attention.
| Frequency | Effects |
|---|---|
| Very common | Bone pain, musculoskeletal pain, headache, weakness/fatigue, raised lactate dehydrogenase (LDH) and alkaline phosphatase, transient leukocytosis |
| Common | Splenomegaly (usually asymptomatic), abdominal pain, injection-site reactions, nausea |
| Uncommon | Capillary leak syndrome (fluid leakage causing swelling and low blood pressure) |
| Rare | Pulmonary infiltrates, interstitial pneumonia, cutaneous vasculitis, Sweet's syndrome |
| Very rare / serious | Splenic rupture, acute respiratory distress syndrome (ARDS), severe allergic reactions/anaphylaxis, sickle cell crisis in patients with sickle cell disease |
Bone pain is usually managed with standard analgesics and does not normally require stopping treatment. Patients should seek urgent medical attention for left upper abdominal or shoulder-tip pain (possible splenic rupture), breathing difficulty, cough, or fever (possible ARDS or capillary leak syndrome), or signs of a severe allergic reaction.
Contraindications of Lenograstim
Contraindications to Lenograstim are limited to the following:
- Known hypersensitivity to Lenograstim or to any excipient in the formulation.
- Concurrent administration with cytotoxic chemotherapy, specifically in the period from 24 hours before to 24 hours after chemotherapy administration, because of the theoretical risk of increased sensitivity of rapidly dividing myeloid precursor cells to cytotoxic agents.
- Use for mobilisation or treatment purposes in patients with myeloid malignancies (other than the specific, physician-directed indications above), including severe congenital neutropenia (Kostmann's syndrome) with abnormal cytogenetics, because of concern about stimulating growth of an abnormal or malignant clone.
Other cautions, such as sickle cell disease, splenic disorders, or pulmonary symptoms, are precautions requiring monitoring rather than absolute contraindications; see Precautions and Warnings.
Frequently Asked Questions about Lenograstim
What is Lenograstim used for?
Lenograstim is used to reduce the duration and severity of low white blood cell counts (neutropenia) after cancer chemotherapy or bone marrow transplantation, and to help mobilise blood stem cells for collection before a stem cell transplant.
How is Lenograstim given?
Lenograstim is given as a subcutaneous injection or, for some uses, a slow intravenous infusion, under medical or specialist nursing supervision. It must never be given in the 24 hours immediately before or after a dose of chemotherapy.
What are the most common side effects of Lenograstim?
Bone pain and general aches are the most common side effects and are usually managed with standard pain relief. Headache, tiredness, and mild abdominal discomfort can also occur.
Can Lenograstim be used during pregnancy or breastfeeding?
Lenograstim should be used in pregnancy only if clearly necessary, after discussion with a physician, because human safety data are limited. Breastfeeding is generally advised against during treatment unless a doctor decides otherwise.
Who should not receive Lenograstim?
Lenograstim should not be given to anyone with a known hypersensitivity to it, should not be given within 24 hours of chemotherapy, and should not be used to mobilise or expand cells in most myeloid blood cancers, including severe congenital neutropenia with abnormal cytogenetics.
What should I do if I miss a dose of Lenograstim or suspect an overdose?
Contact your treating team promptly if a dose is missed, as timing relative to chemotherapy matters. If an overdose is suspected, seek immediate medical attention or contact emergency services, since specialist monitoring of blood counts is required.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.