How it is administered

Pegfilgrastim is given as a subcutaneous (under the skin) injection. It is available in several forms, including:

• Prefilled syringes for manual injection (6 mg/0.6 mL)
• On-body injector devices (for some brands)
• Prefilled autoinjectors (for some brands)

The typical adult dose is a single 6 mg injection once per chemotherapy cycle. For children under 45 kg, dosing is based on body weight. The injection is usually given at least 24 hours after chemotherapy and not within 14 days before chemotherapy.

For pediatric dosing, refer to the specific dosing table in the medication instructions.

How it works

Pegfilgrastim is a colony-stimulating factor. It works by binding to specific receptors on blood-forming cells in the bone marrow, stimulating them to grow and mature into neutrophils—a type of white blood cell that helps fight infection.

Chemotherapy for blood cancers like Acute Myeloid Leukemia (AML) can lower your white blood cell count, increasing your risk of infection. Pegfilgrastim helps your body recover these cells more quickly, reducing the duration and severity of neutropenia (low neutrophil count) and lowering the risk of developing infections and fever during chemotherapy.

By supporting your immune system during treatment, pegfilgrastim helps you stay on schedule with your cancer therapy and reduces the likelihood of infection-related complications.

Who Should take it

Pegfilgrastim is recommended for patients with non-myeloid cancers (cancers that do not start in the bone marrow) who are receiving chemotherapy that is likely to cause a significant drop in white blood cells, leading to a risk of febrile neutropenia (fever and low neutrophil count).

It is commonly used in patients with blood cancers such as lymphoma, but not in those with myeloid cancers like AML as a primary treatment. However, it may be used in AML patients to help manage neutropenia after chemotherapy, depending on your doctor’s recommendation.

Pegfilgrastim is also approved to increase survival in patients exposed to high doses of radiation that suppress bone marrow function.

Who should not take it

Pegfilgrastim should not be used in patients who have had serious allergic reactions to pegfilgrastim, filgrastim, or other granulocyte colony-stimulating factors. Reactions can include anaphylaxis (a severe allergic response).

It is not indicated for patients with myeloid cancers (such as AML or myelodysplastic syndromes) as a primary therapy, because it may theoretically stimulate the growth of malignant cells. Use in these patients should be carefully considered by your doctor.

Patients with sickle cell disease should use pegfilgrastim with caution, as it can trigger sickle cell crises.

Commonly used with

Pegfilgrastim is commonly used alongside chemotherapy regimens for various cancers, including blood cancers. It is not a chemotherapy drug itself, but is used to support your immune system during treatment.

It may also be used with other supportive care medications such as anti-nausea drugs, antibiotics (if infection risk is high), and pain relievers.

Commonly tested with

Pegfilgrastim has been tested in combination with a variety of chemotherapy drugs, especially those known to cause neutropenia, such as doxorubicin, docetaxel, and cyclophosphamide.

It is also compared in studies with filgrastim (another colony-stimulating factor) to evaluate effectiveness in reducing neutropenia and infection risk. In pediatric studies, it has been tested in children with sarcoma receiving chemotherapy.