Chemotherapy has many side effects including nausea, vomiting, diarrhea, constipation, hair loss, anemia, numbness or tingling in the arms and legs, fatigue, insomnia and itchy skin. One of the most worrisome side effects is decreased immune system function, largely from bone marrow suppression. There are drugs available to increase immunity in some patients at risk of infection from chemotherapy.
Filgrastim
Filgrastim and pegfilgrastim are drugs in the category of G-CSFs. G-CSF stands for granulocyte-colony stimulating factor. It stimulates the production of a type of cell known as a neutrophil, which is one type of white blood cell. Filgrastim, whose brand name is Neupogen, is G-CSF that is made by yeast for use in humans. Patients with certain blood cancers such as acute myeloid leukemia and chronic myeloid leukemia should not take the drug because it can make these conditions worse. There are no common side effects. Less common side effects include bone and muscle pain. Rare problems include allergic reactions and spleen problems. (See Reference 1 and 3)
Pegfilgrastim
Pegfilgrastim, brand name Neulasta, is a G-CSF that is longer lasting than filgrastim. According to a study published in the "Annals of Oncology" by F.A. Holmes, pegfilgrastim is as effective as filgrastim but requires fewer injections. Side effects may include fever, chills, sore throat, cough and mouth sores. Shortness of breath may also occur but is more rare. (See References 1 and 4)
Sargramostim
Sargramostim, brand name Leukine, is a similar drug to filgrastim and pegfilgrastim. It is known as a GM-CSF, which stands for granulocyte-macrophage colony stimulating factor. Like G-CSF, it stimulates the bone marrow to cause increased neutrophils. However, it also increases levels of other types of immune cells. According to a study in Pharmacotherapy by Milkovich, et al., fever not caused by infection is more common with sargramostim, as are diarrhea, fatigue, reactions at the injection site, other skin disorders and swelling. Skeletel pain is less common. (See Reference 2)
References
- "Annals of Oncology"; Comparable efficacy and safety profiles of once-per-cycle pegfilgrastim and daily injection filgrastim in chemotherapy-induced neutropenia: a multicenter dose-finding study in women with breast cancer.; F.A. Holmes et al; 2002
- "Pharmacotherapy"; Comparative safety of filgrastim versus sargramostim in patients using myelosuppressive therapy. Milkovich et al. Dec 2000
- American Cancer Society: Filgrastim
- Mayo Clinic: Pegfilgrastim
