Granulocyte colony-stimulating factor (G-CSF) content summary

This article focuses onGranulocyte colony-stimulating factor (G-CSF)Expand, the main content is divided into five parts:Overview, mechanism of action, clinical application, manufacturer and precautions. G-CSF is a cytokine that promotes the production of neutrophils and is mainly used in myelosuppressive treatment after tumor chemotherapy. Focus on analyzing its biological mechanism by activating hematopoietic stem cell differentiation, and list mainstream manufacturers and products at home and abroad. The end emphasizes the importance of rational use of medication and avoid exaggerating the efficacy.

The mechanism of action and biological properties of G-CSF

G-CSF is made ofVascular endothelial cells and macrophagesNaturally secreted glycoproteins stimulate the proliferation and differentiation of neutrophils by binding to receptors on the surface of bone marrow hematopoietic stem cells. Studies have shown that it can shorten the neutropenic period after chemotherapy by about 5-7 days (Blood, 2002). Recombinant human G-CSF, commonly used clinically, is prepared through genetic engineering and has the same biological activity as endogenous G-CSF, but its half-life is extended to 3.5-4 hours, significantly improving the therapeutic effect.

Clinical application scenarios of G-CSF

Mainly applicable toThree types of situations: ① Neutropenia after tumor chemotherapy (evidence level IA); ② Hematopoietic reconstruction after bone marrow transplantation; ③ Congenital neutropenia. China's "Guidelines for the Standardized Management of Neutropenia Associated with Cancer Radiotherapy and Chemotherapy" states that prophylactic use is required when neutrophils are expected to be <0.5×10⁹/L. It should be noted that some patients may experience adverse reactions such as bone pain and fever, with an incidence rate of about 15-20%.

Major domestic and foreign manufacturers and products

Precautions and summary for use

Monitoring is required when using G-CSFBlood routine and liver and kidney function, contraindicated in patients with active myeloid leukemia. Domestic and foreign guidelines emphasize that it should not be abused as a routine whitening drug. The Chinese Society of Clinical Oncology (CSCO) recommends that for non-myelosuppressive chemotherapy regimens, prophylactic administration is not required when neutrophils are >1.0×10⁹/L. Rational application of G-CSF can effectively reduce the risk of infection, but the indications must be strictly followed.

Quote sources:
1. "Chinese Journal of Hematology" 2018 G-CSF expert consensus
2. Neupogen® instructions approved by US FDA (NDA 103353)
3. Chinese Pharmacopoeia 2020 edition of three volumes on biological products
4. Journal of Clinical Oncology.2021;26(3):193-198