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How it is administered
Pegfilgrastim is given as a subcutaneous (under the skin) injection. It is typically supplied in a prefilled syringe containing 6 mg in 0.6 mL, designed to deliver the entire contents in one injection. The injection is usually given once per chemotherapy cycle, at least 24 hours after the end of chemotherapy and not within 14 days before starting the next cycle.
For children weighing less than 45 kg, dosing is based on body weight. The medication is also available in different devices, such as prefilled syringes, autoinjectors, and on-body injectors (for some brands), but all are for subcutaneous use only.
How it works
Pegfilgrastim is a type of medicine called a colony-stimulating factor. It works by stimulating the bone marrow to produce more neutrophils, a type of white blood cell that helps fight infections. Chemotherapy for blood cancers like follicular lymphoma can lower your white blood cell count, making you more prone to infections. Pegfilgrastim binds to specific receptors on blood-forming cells in the bone marrow, encouraging them to multiply and mature into fully functioning neutrophils.
By increasing neutrophil production, pegfilgrastim helps reduce the risk of developing febrile neutropenia (a fever with low white blood cell count), which can be a serious complication during chemotherapy. This support allows patients to continue their cancer treatment with fewer interruptions due to infections.
Common side effects
The most common side effects of pegfilgrastim are:
- Bone pain (31% of patients)
- Pain in the arms or legs (9%)
Other possible side effects include:
- Allergic reactions (rash, hives, swelling, anaphylaxis)
- Injection site reactions
- Headache
- Nausea
- Fatigue
Serious but rare side effects can include:
- Splenic rupture (pain in the upper left abdomen or shoulder)
- Acute respiratory distress syndrome (trouble breathing)
- Glomerulonephritis (kidney inflammation)
- Capillary leak syndrome (swelling, low blood pressure)
- Leukocytosis (high white blood cell count)
- Thrombocytopenia (low platelet count)
- Aortitis (inflammation of the aorta)
If you experience any severe symptoms, contact your healthcare provider immediately.
Who Should take it
Pegfilgrastim is recommended for patients with non-myeloid cancers, such as follicular lymphoma, who are receiving chemotherapy that is likely to cause a significant drop in white blood cell counts (neutropenia). It is used to decrease the risk of infection, as shown by the development of fever and low neutrophil counts (febrile neutropenia).
Pegfilgrastim is not used to treat cancer directly, but rather to support your immune system during chemotherapy. It is also approved for use in children and adults, with special dosing for pediatric patients based on their weight. It is not used for mobilizing stem cells for transplantation.
Who should not take it
You should not take pegfilgrastim if you have had a serious allergic reaction to pegfilgrastim, filgrastim, or any other granulocyte colony-stimulating factors. Reactions can include anaphylaxis, which is a life-threatening allergic response.
People with certain blood disorders, such as myeloid cancers (like acute myeloid leukemia or myelodysplastic syndromes), should not use pegfilgrastim, as it may stimulate the growth of these cancer cells. If you have sickle cell disease, pegfilgrastim can increase the risk of a sickle cell crisis and should be used with caution or avoided. Always tell your doctor about your full medical history before starting this medication.
Commonly used with
Pegfilgrastim is commonly used alongside chemotherapy regimens for blood cancers such as follicular lymphoma. It is not a cancer treatment itself, but helps support the immune system during chemotherapy.
It may be used with a variety of chemotherapy drugs, but your healthcare team will decide the best timing and combination for your specific treatment plan.
Commonly tested with
Pegfilgrastim has been tested in combination with various chemotherapy regimens, including those containing doxorubicin, docetaxel, and other cytotoxic agents used to treat blood cancers. In clinical studies, it is often compared to filgrastim (another colony-stimulating factor) or placebo to evaluate its effectiveness in reducing the duration of neutropenia and the risk of infection.
It is also tested in pediatric populations and in patients with different types of non-myeloid cancers to ensure safety and effectiveness across age groups and cancer types.
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