Treatment with Neutrostim® should only be performed under the supervision of a physician who has experience with colony-stimulating factors, provided that the necessary diagnostic capabilities are available.
The safety and efficacy of filgrastim in patients with myelodysplastic syndrome and chronic myeloid leukemia have not been established, and in connection with these diseases, filgrastim Not recommended. Particular attention should be given to the differential diagnosis between acute myelogenous leukemia and blast crisis of chronic myelogenous leukemia.
Before the appointment of Neutrostim® to patients with severe chronic neutropenia (TCN), a differential diagnosis should be carefully conducted to exclude other hematologic diseases such as aplastic anemia, myelodysplasia and chronic myeloid leukemia (morphological and cytogenetic bone marrow analysis should be performed before the start of therapy).
When filgrastim was used in patients with THC, cases of myelodysplastic syndrome (MDS) and acute myeloblastic leukemia were noted.Despite the fact that the relationship of the development of these diseases with filgrastim is not established, the drug should be used with TCN with caution under the control of the morphological and cytogenetic analysis of the bone marrow (1 every 12 months). When cytogenetic abnormalities appear in the bone marrow, the risk and benefit of further therapy with filgrastim should be carefully assessed. With the development of MDS or leukemia, Neutrostim® should be discontinued.
Treatment with Neutrostim® should be carried out under regular control of a general blood test, with a calculation of the leukocyte count and the number of platelets (before starting therapy and then twice a week with standard chemotherapy).
With a stable platelet count of less than 100,000 / μL, it is recommended that you temporarily discontinue Neutrostim® therapy or reduce its dose.
Filgrastim does not prevent, caused by myelosuppressive chemotherapy, thrombocytopenia and anemia.
During treatment with Neurostim®, urine tests should be performed regularly (to exclude hematuria and proteinuria) and control the size of the spleen.
Neutrostim® should be used with caution in patients with sickle cell disease due to the possible development of a marked increase in the number of sickle cells.
The safety and efficacy of filgrastim in newborns and patients with autoimmune neutropenia have not been established.
Patients with bone pathology and osteoporosis receiving continuous treatment with Neutrostim® for more than 6 months are shown to control the density of bone tissue.