A 62-year-old man with non-Hodgkin lymphoma is undergoing chemotherapy and has neutropenia. Which medicine is most appropriate to prescribe to reduce the risk of neutropenic complications in future cycles?

A 62-year-old man with non-Hodgkin lymphoma is undergoing chemotherapy and has neutropenia. Which medicine is most appropriate to prescribe to reduce the risk of neutropenic complications in future cycles?

• A. Filgrastim
• B. Epoetin alfa
• C. Pegfilgrastim
• D. Oprelvekin

Answer: (A)

Neutropenia from chemotherapy raises the risk of infection, and using a growth factor that boosts neutrophil production helps prevent febrile neutropenia in future cycles. Filgrastim is a recombinant human G-CSF that stimulates the bone marrow to produce neutrophils and speeds their recovery after each chemotherapy cycle. By reducing the duration and depth of neutropenia, it lowers the chance of infection and allows chemotherapy to be given on schedule with maintained dose intensity. It’s typically given as daily subcutaneous injections after chemotherapy until the absolute neutrophil count recovers. Epoetin alfa increases red blood cell production, not neutrophils, so it doesn’t address neutropenia. Oprelvekin boosts platelets, not neutrophils, for thrombocytopenia. Pegfilgrastim is a long-acting G-CSF given once per cycle and would also prevent neutropenia, but the classic choice for this purpose in many contexts is filgrastim due to its well-established dosing and safety profile across cycles.

Neutropenia from chemotherapy raises the risk of infection, and using a growth factor that boosts neutrophil production helps prevent febrile neutropenia in future cycles. Filgrastim is a recombinant human G-CSF that stimulates the bone marrow to produce neutrophils and speeds their recovery after each chemotherapy cycle. By reducing the duration and depth of neutropenia, it lowers the chance of infection and allows chemotherapy to be given on schedule with maintained dose intensity. It’s typically given as daily subcutaneous injections after chemotherapy until the absolute neutrophil count recovers.

Epoetin alfa increases red blood cell production, not neutrophils, so it doesn’t address neutropenia. Oprelvekin boosts platelets, not neutrophils, for thrombocytopenia. Pegfilgrastim is a long-acting G-CSF given once per cycle and would also prevent neutropenia, but the classic choice for this purpose in many contexts is filgrastim due to its well-established dosing and safety profile across cycles.