Lenograstim

Summary

Lenograstim is a recombinant glycosylated form of human granulocyte colony-stimulating factor (rHuG-CSF) used to reduce the duration of neutropenia and associated complications in patients receiving myelosuppressive chemotherapy, undergoing bone marrow transplantation, or mobilizing peripheral blood progenitor cells. Unlike filgrastim, lenograstim is glycosylated, which may confer greater stability and slightly different pharmacokinetics.

Mechanism of Action

Binds to G-CSF receptors on hematopoietic progenitor cells, stimulating proliferation, differentiation, and activation of neutrophil precursors, thereby increasing neutrophil production and function.

Routes of Administration

Goals & Uses

• Reduction of chemotherapy-induced neutropenia durationHematologic SupportHigh
• Accelerating neutrophil recovery post bone marrow transplantTransplantation SupportHigh
• Treatment of severe chronic neutropeniaHematologic DisorderModerate
• Prevention of infections in neutropenic patientsInfection ProphylaxisHigh
• Mobilization of peripheral blood progenitor cells (PBPC)Stem Cell TransplantationHigh

Contraindications

• Myeloid malignancies (AML, CML) not receiving cytotoxic therapyOncologicHigh
• Hypersensitivity to lenograstim or E. coli-derived proteinsAllergy/ImmunologicHigh
• Concomitant cytotoxic chemotherapy or radiotherapy (within 24 hours)Drug Interaction / TimingHigh

Adverse Effects

• Splenomegaly / splenic ruptureOrgan ToxicityUncommon
• Injection site reactionsLocalCommon
• LeukocytosisHematologicCommon
• ThrombocytopeniaHematologicUncommonLow platelet count
• Pulmonary adverse events (ARDS, interstitial pneumonia)RespiratoryRare
• Bone pain / musculoskeletal painMusculoskeletalCommon

Drug Interactions

• Cytotoxic chemotherapy agentsHigh
• BleomycinModerate
• LithiumLow

Population Constraints

• Pediatric patientsAgeRelative
• Patients with sickle cell diseaseHematologic DisorderRelative
• Patients with pre-existing myeloid disordersOncologicRelative
• Pregnant womenReproductiveRelative

Regulatory Status

• European UnionApprovedApproved: Reduction of neutropenia duration in cytotoxic chemotherapy recipients, Mobilization of peripheral blood progenitor cells, Accelerating neutrophil recovery after bone marrow transplantation, Severe chronic neutropeniaApproved under the brand name Granocyte; marketed in numerous EU member states.
• United StatesUnapprovedNot approved by the FDA; filgrastim and pegfilgrastim are the primary G-CSF products available in the US.
• United KingdomApprovedApproved: Reduction of neutropenia duration following myelosuppressive chemotherapy, Peripheral blood progenitor cell mobilization, Post-bone marrow transplant neutrophil recoveryApproved pre-Brexit; continues to be available under MHRA oversight post-Brexit.

Approved in the EU and several other countries; not approved by the US FDA. Marketed primarily in Europe and Japan. Not interchangeable with other G-CSF products without clinical assessment.

Evidence & Sources

No sources recorded yet.