G-CSF

Caitlin Soto, PharmD, BCIDP, Kathryn Dzintars, Pharm.D., BCPS

INDICATIONS

FDA

  • Below are primarily filgrastim indications:
    • Prevention of chemotherapy-associated febrile neutropenia in nonmyeloid malignancies
    • Shortens neutrophil recovery time and fever after AML induction/consolidation.
    • Neutropenia following bone marrow transplantation
    • Autologous mobilization of hematopoietic progenitor cells for collection by leukapheresis
    • Symptomatic severe chronic congenital, cyclic, or idiopathic neutropenia
    • Increased survival in patients acutely exposed to myelosuppressive doses of radiation (Hematopoietic Syndrome of Acute Radiation Syndrome)
  • Pegfilgrastim and tbo-filgrastim do not automatically share every indication.

NON-FDA APPROVED USES

  • Severe neutropenia associated with HIV and/or opportunistic infections
  • Selected severe drug-induced neutropenia/agranulocytosis, particularly with infection or anticipated prolonged neutropenia.
    • Prolonged β-lactam and vancomycin exposure are potential examples.
  • Prolonged neutropenia/immune effector cell-associated hematologic toxicity (ICAHT) after CAR T-cell therapy.
    • EHA/EBMT permits consideration of G-CSF from day +2 in selected patients at high risk for hematotoxicity. Timing should follow the cellular-therapy team’s protocol, product guidance, and concurrent CRS/ICANS.

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Last updated: October 7, 2026