Leuchokam - instructions for use, reviews, analogs and forms of release (injections in ampoules for intravenous and subcutaneous injections) drugs for the treatment of neutropenia in adults, children and pregnancy

In this article, you can read the instructions for using the drug Lechkostyam. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Leikostim in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Leuchimim in the presence of existing structural analogs. Use for the treatment of neutropenia in malignant blood diseases in adults, children, as well as in pregnancy and lactation.

Lechkostyam - granulocyte colony-stimulating factor. Immunomodulator.It is a highly purified, non-glycosylated protein. Regulates the production of functional neutrophils and their release into the blood from the bone marrow. Causes a marked increase in neutrophils within 24 hours and a slight increase in monocytes.

Indications

• to reduce the duration of neutropenia and the frequency of febrile neutropenia in patients receiving chemotherapy with cytotoxic agents for malignant diseases (with the exception of chronic myelogenous leukemia and myelodysplastic syndrome), as well as a reduction in the duration of neutropenia and its clinical consequences in patients receiving myeloablative therapy followed by bone marrow transplantation;
• for the mobilization of autologous progenitor cells of hemopoiesis in peripheral blood (including after myelosuppressive therapy), to accelerate the recovery of hemopoiesis by the administration of these cells after myelosuppression or myeloablation;
• prolonged therapy to increase the number of neutrophils and reduce the frequency and duration of infectious complications in children and adults with severe congenital, periodic or malignant neutropenia (absolute neutrophil count <500 / μl) and severe or recurrent infections in the anamnesis.

Forms of release

Solution for intravenous and subcutaneous injection (injections in ampoules for injection).

Instructions for use and dosing regimen

Individual, depending on the indications and treatment regimen. The drug is used for treatment in a hospital, treatment in an outpatient setting is not allowed.

Side effect

• pain in muscles or bones;
• dysuria;
• transient arterial hypotension;
• symptoms indicating reactions of an allergic type (about half of them were associated with the administration of the first dose).

Contraindications

• severe congenital neutropenia (Costman's syndrome) with cytogenetic disorders;
• increased sensitivity to filgrastim (active substance of the drug Leicostim).

Application in pregnancy and lactation

Safety of use in pregnancy is not established, so the expected benefit of therapy for the mother and the potential risk to the fetus should be assessed.

If necessary, use during lactation should stop breastfeeding.

special instructions

It is not recommended for patients with severe impairment of renal or hepatic function. The efficacy and safety of filgrastim in this category of patients has not been studied.

Patients with concomitant osteal pathology and osteoporosis who receive Leukosten continuously for more than 6 months are advised to control bone density.

The efficacy of filgrastim in patients with a significantly reduced number of myeloid progenitor cells has not been studied. Filgrastim increases the number of neutrophils by first affecting the neutrophil precursor cells. Therefore, in patients with a reduced content of progenitor cells (for example, those subjected to intensive radiation therapy or chemotherapy), the degree of increase in the number of neutrophils may be lower.

Granulocyte colony-stimulating factor of a person can cause the growth of myeloid cells in vitro. Similar effects can be observed in vivo and in some nonmyeloid cells. The safety and efficacy of filgrastim in patients with myelodysplastic syndrome and chronic myeloid leukemia have not been established, therefore, it is not indicated in these diseases. A differential diagnosis should be made especially between the blast-transformation of chronic myelogenous leukemia and acute myeloid leukemia.

During the treatment period it is necessary to regularly determine the number of leukocytes.If after passing the expected minimum it exceeds 50,000 / μL filgrastim should be immediately canceled. If filgrastim used for mobilization of peripheral blood hematopoietic progenitor cells, it is canceled in the case where the number of cells exceeds 100 000 / mkl.

With extreme caution should be used in patients receiving high-dose cytotoxic chemotherapy.

Monotherapy with Leucimam does not prevent thrombocytopenia and anemia caused by myelosuppressive chemotherapy. It is recommended to regularly determine the number of platelets and hematocrit. Particular caution should be exercised when applying single-component or combination chemotherapeutic regimens, known for their ability to cause severe thrombocytopenia.

Before using filgrastim in severe chronic neutropenia should be particularly careful to conduct differential diagnosis with other hematological diseases such as aplastic anemia, myelodysplasia, and myeloid leukemia. Prior to treatment should be carried out with the full blood count and determination of leukocyte platelet counts, as well as explore morphologic picture of bone marrow and karyotype.

Care should be taken to monitor the blood picture, incl. number of platelets, especially during the first few weeks of treatment with filgrastim. When thrombocytopenia (the number of platelets stably below 100,000 / μL) should consider the temporary withdrawal of filgrastim or a decrease in dose. There are also other changes in the blood formula, which require its careful monitoring, incl. anemia and a transient increase in the number of myeloid progenitor cells.

During the period of treatment, the size of the spleen should be regularly monitored, urinalysis should be performed.

Estimating the number of progenitor cells mobilized in patients with filgrastim should pay special attention to the method of quantitative determination. The results of a flow cytometric analysis of the number of CD34 + cells differ depending on the particular methodology, and care should be taken for recommendations based on the number of studies conducted in other laboratories.

Special studies of the efficacy and safety of filgrastim in elderly patients were not conducted.

Safety and efficacy in newborns and patients with autoimmune neutropenia have not been established.

Analogues of the drug Leicostim

Structural analogs for the active substance:

• Granogen;
• Grazalva;
• Zarcio;
• The Immigra;
• Leucite;
• Myelastra;
• Neupogen;
• Neuromax;
• Neutrostim;
• Tevagrastim;
• Filgrastim;
• Filerim.

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