필그라스팀

사이토카인 조혈제

**필그라스팀(Filgrastim)**은 수의학에서 골수를 자극하여 호중구를 생성하도록 돕는 재조합 인간 과립구 집락 자극 인자(G-CSF)입니다. 주요 임상 포인트: * **주요 적응증:** 심각하고 생명을 위협하는 호중구 감소증(예: 파보바이러스 감염, 화학요법으로 인한 골수 억제, 고양이 백혈병 바이러스 관련 주기적 호중구 감소증)에 사용됩니다. * **면역원성 위험:** 인간 DNA에서 유래했기 때문에 개와 고양이에게 **강한 면역 반응**을 유발할 수 있습니다. 환자는 외부에서 투여된 약물뿐만 아니라 체내에서 자연적으로 생성되는 G-CSF에 대해서도 중화 항체를 형성할 수 있으며, 이는 심각하고 장기적이며 치명적인 호중구 감소증으로 이어질 수 있습니다. * **임상 전략:** 항체 형성을 최소화하기 위해 일반적으로 호중구 수치가 가장 낮은 위험한 시기에만 짧은 **"펄스" 요법**(3~5일)으로 투여합니다. * **비용:** 치료 비용이 매우 비싸기 때문에 일반적인 수의 임상에서의 사용이 제한되는 경우가 많습니다.

작용 기전: Filgrastim acts as a hematopoietic growth factor. * It binds specifically to **G-CSF receptors** located on the surface of myeloid progenitor cells in the bone marrow. * Receptor activation triggers intracellular signaling pathways (such as the **JAK/STAT pathway**) → stimulates the proliferation, differentiation, and activation of progenitor cells exclusively within the **neutrophil-granulocyte lineage**. * **Clinical Pearl:** In addition to increasing the absolute number of circulating mature neutrophils, filgrastim also enhances the functional capacity of these cells, including their phagocytic and bactericidal activities, thereby improving the patient's ability to fight off bacterial infections during periods of severe immunosuppression.

동물 종별 용량

Dogs

Adjunctive therapy of neutropenia (secondary to drug induced aplastic pancytopenia) · 5 micrograms/kg SC daily · SC · daily · Pulse therapy of no more than 5 days · To avoid autoantibody formation, pulse therapy is recommended.
Neutropenia · 1-5 micrograms/kg SC daily · SC · daily · Pulse therapy of no more than 5 days · To avoid autoantibody formation, pulse therapy is recommended.
Neutropenia · 100,000-500,000 IU (1-5 micrograms)/kg · SC · q24h · 3-5 days · Neutrophil counts typically rise within 24 hours.

Cats

Neutropenia secondary to drug toxicity, infectious diseases, FeLV associated cyclic neutropenia or idiopathic causes · 5 micrograms/kg SC twice daily · SC · twice daily · Pulse therapy of no more than 5 days · Cost and/or development of antibodies usually limit usefulness to a few weeks, but often it is effective for acute or lifethreatening neutropenia.
Neutropenia · 1-5 micrograms/kg SC daily · SC · daily · Pulse therapy of no more than 5 days · To avoid autoantibody formation, pulse therapy is recommended.
Adjunctive therapy of neutropenia · 5 micrograms/kg SC daily until neutrophil count exceeds 3,000/mcl for 2 days · SC · daily · Until neutrophil count exceeds 3,000/mcl for 2 days (ideally ≤ 5 days) · To avoid autoantibody formation, pulse therapy is recommended.
Neutropenia · 100,000-500,000 IU (1-5 micrograms)/kg · SC · q24h · 3-5 days · Neutrophil counts typically rise within 24 hours.

용량은 면허 수의 전문가를 위한 임상 참고 자료입니다. 항상 최신 라벨과 개별 환자에 대해 확인하십시오.

투여 경로

금기

Hypersensitivity to filgrastim
Patients that have previously developed antibodies to filgrastim with resultant neutropenia

이상반응

Severe neutropenia (due to autoantibody formation against G-CSF)
Myelofibrosis (theoretical/reported concern)
Medullary histiocytosis (theoretical/reported concern)
Injection site irritation
Bone pain
Splenomegaly
Hypotension

약물 상호작용

Antineoplastics · Avoid using filgrastim within 24 hours of administering antineoplastic agents that target rapidly proliferating cells, as it may exacerbate toxicity to the newly stimulated myeloid cells.
Corticosteroids · May potentiate the release of neutrophils during G-CSF therapy. · moderate
Lithium · May potentiate the release of neutrophils during G-CSF therapy. · moderate
Cytotoxic Chemotherapy · Concurrent administration may increase the incidence of adverse effects. The stimulatory effects of G-CSF on haemopoietic precursors render them more susceptible to the effects of chemotherapy. · major

모니터링

CBC with platelets, routinely (to monitor neutrophil response and detect potential antibody-induced neutropenia)

과용량

Limited information is available regarding acute toxicity. Because of the high expense of the drug and its apparent limited acute toxic potential, clinically significant overdoses are considered unlikely. If an overdose occurs, monitor CBC closely and provide supportive care.

VetSheet 약물 레퍼런스는 면허 수의 전문가를 위한 임상 의사결정 보조 도구이며, 전문적 판단이나 제조사의 최신 라벨을 대신하지 않습니다.