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Neutrophil recovery following induction chemotherapy for acute myeloid leukaemia
Adult: To shorten the time for neutrophil recovery and decrease the incidence of severe or fatal infections after induction chemotherapy: ≥55 years 250 mcg/m2 daily via infusion over 4 hours, starting approx on day 11 or 4 days after the completion of induction chemotherapy (if the day 10 bone marrow is hypoplastic with <5% blasts). If a 2nd cycle of induction chemotherapy is needed, administer approx 4 days following the completion of chemotherapy (if the bone marrow is hypoplastic with <5% blasts). Continue until an absolute neutrophil count (ANC) of >1,500 cells/mm3 for 3 consecutive days or a Max of 42 days. Do not administer within 24 hours prior to or following radiotherapy or chemotherapy. Dose reduction, dosing interruption, or discontinuation may be required according to individual safety or tolerability (refer to detailed product guideline).
Intravenous
Acceleration of myeloid reconstitution following allogeneic bone marrow transplantation
Adult: In patients undergoing bone marrow transplantation from HLA-matched related donors: 250 mcg/m2 daily via infusion over 2 hours starting 2-4 hours following bone marrow infusion, and at least 24 hours after the last dose of chemotherapy or radiotherapy. Do not administer until the post marrow infusion ANC is <500 cells/mm3. Continue until an ANC >1,500 cells/mm3 for 3 consecutive days is achieved. Do not administer within 24 hours prior to radiotherapy or chemotherapy. Dose reduction, dosing interruption, or discontinuation may be required according to individual safety or tolerability (refer to detailed product guideline).
Child: ≥2 years Same as adult dose.
Child: ≥2 years Same as adult dose.
Intravenous
Acceleration of myeloid reconstitution following autologous bone marrow transplantation
Adult: In patients with non-Hodgkin lymphoma (NHL), acute lymphoblastic leukaemia (ALL), and Hodgkin lymphoma (HL): 250 mcg/m2 daily via infusion over 2 hours starting 2-4 hours following bone marrow infusion, and at least 24 hours after the last dose of chemotherapy or radiotherapy. Do not administer until the post marrow infusion ANC is <500 cells/mm3. Continue until an ANC >1,500 cells/mm3 for 3 consecutive days is achieved. Do not administer within 24 hours prior to radiotherapy or chemotherapy.
Child: ≥2 years Same as adult dose.
Child: ≥2 years Same as adult dose.
Intravenous, Subcutaneous
Mobilisation of peripheral blood progenitor cells
Adult: In cancer patients who are undergoing autologous haematopoietic stem cell transplantation for the mobilisation of haematopoietic progenitor cells into peripheral blood for collection by leukapheresis: 250 mcg/m2 daily via continuous IV infusion over 24 hours or via SC inj once daily; continue the same dose throughout peripheral blood progenitor cell collection period. Reduce dose by 50% if WBC is >50,000 cells/mm3. Consider other mobilisation therapy if the numbers of the collected progenitor cells are inadequate.
Intravenous, Subcutaneous
Acceleration of myeloid reconstitution following autologous peripheral blood progenitor cell transplantation
Adult: In patients with NHL, ALL, and HL: 250 mcg/m2 daily via continuous IV infusion over 24 hours or via SC inj once daily, starting immediately after infusion of progenitor cells. Continue until an ANC >1,500 cells/mm3 for 3 consecutive days is achieved. Do not administer within 24 hours prior to or following radiotherapy or chemotherapy.
Child: ≥2 years Same as adult dose.
Child: ≥2 years Same as adult dose.
Intravenous
Delayed neutrophil recovery following allogeneic bone marrow transplantation, Delayed neutrophil recovery following autologous bone marrow transplantation, Graft failure following allogeneic bone marrow transplantation, Graft failure following autologous bone marrow transplantation
Adult: 250 mcg/m2 daily for 14 days via infusion over 2 hours; may be repeated after 7 days off-therapy if neutrophil recovery or engraftment has not occurred. If neutrophil recovery still has not occurred, a 3rd course of 500 mcg/m2 daily for 14 days may be attempted after another 7 days off-therapy, if necessary. Dose reduction, dosing interruption, or discontinuation may be required according to individual safety or tolerability (refer to detailed product guideline).
Child: ≥2 years Same as adult dose.
Child: ≥2 years Same as adult dose.
Subcutaneous
Haematopoietic subsyndrome of acute radiation syndrome
Adult: 7 mcg/kg once daily. Initiate as soon as possible after confirmed or suspected exposure to radiation doses >2 gray (Gy). Continue until the ANC remains >1,000/mm3 for 3 consecutive CBCs or >10,000/mm3 after a radiation-induced nadir.
Child: <15 kg: 12 mcg/kg once daily; 15-40 kg: 10 mcg/kg once daily; >40 kg: Same as adult dose. Initiate as soon as possible after confirmed or suspected exposure to radiation doses >2 Gy. Continue until the ANC remains >1,000/mm3 for 3 consecutive CBCs or >10,000/mm3 after a radiation-induced nadir.
Child: <15 kg: 12 mcg/kg once daily; 15-40 kg: 10 mcg/kg once daily; >40 kg: Same as adult dose. Initiate as soon as possible after confirmed or suspected exposure to radiation doses >2 Gy. Continue until the ANC remains >1,000/mm3 for 3 consecutive CBCs or >10,000/mm3 after a radiation-induced nadir.
