Filgrastim
is typically dosed in the 10 microgram/kg level for 4–5 days during the
harvesting of stem cells. The documented adverse effects of filgrastim
include splenic rupture (indicated by left upper abdominal or shoulder
pain, risk 1 in 40000), Adult respiratory distress syndrome (ARDS),
alveolar hemorrage, and allergic reactions (usually expressed in first
30 minutes, risk 1 in 300). In addition, platelet and hemoglobin levels
dip post-procedure, not returning to normal until one month.
The
question of whether geriatrics (patients over 65) react the same as
patients under 65 has not been sufficiently examined. Coagulation issues
and inflammation of atherosclerotic plaques are known to occur as a
result of G-CSF injection. G-CSF has also been described to induce
genetic changes in mononuclear cells of normal donors. There is evidence that myelodysplasia (MDS) or acute myeloid leukaemia (AML) can be induced by GCSF in susceptible individuals.
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