Boosting WBC counts during chemotherapy

Nursing, May 2002

DRUG NEWS

NEULASTA

A common adverse effect of chemotherapy, febrile neutropenia can be life-threatening. The FDA has approved Neulasta (pegfilgrastim) to boost production of infection-fighting white blood cells (WBC) in patients with nonmyeloid malignancies who are receiving immunosuppressive anticancer drugs. Administered as a single injection during each chemotherapy cycle, Neulasta has an advantage over Neupogen (filgrastim), the only other drug available for this indication. Neupogen is given daily during chemotherapy.

Although similar to Neupogen, Neulasta has had a polyethylene glycol molecule ("PEG" unit) added to enlarge its filgrastim molecules. This extends the drugs half-life and prolongs its beneficial effects in the body. Drug clearance is regulated by neutrophils, so the drug remains in the blood while the patient needs itwhen he's neutropenic-and clears rapidly when neutrophil levels rise.

In clinical trials, the new drug was well tolerated and safe. The most common adverse reaction was bone pain, which in most cases responded to nonnarcotic analgesics.

Neulasta is a product of Amgen.