Systemic Anti-Cancer Therapy Regimen Library
HSCT Mobilisation - CYCLOPHOSPHamide and filgrastim
Treatment Overview
This regimen contains a medicine where one or more biosimilars may exist. Any biosimilars used have been reviewed by the regulator (Medsafe) and relevant specialists were consulted nationally. Where regulators, in consultation with relevant specialists, have agreed that there are no clinically significant differences in either safety or effectiveness between a biosimilar and originator product, these drugs may be used interchangeably.
Cycle 1 - 14 days
filgrastim: Give filgrastim 10 microgram/kg subcutaneously ONCE daily from Day 5 for 4 or 5 days until stem cell harvest complete.
Cycle details
Cycle 1 - 14 days
| Medication | Dose | Route | Days | Max Duration |
|---|---|---|---|---|
| mesna * | 2000 mg/m² | intravenous | 1 | 5 hours |
| sodium chloride | 0.9 % | intravenous | 1 | 120 minutes |
| CYCLOPHOSPHamide * | 2000 mg/m² | intravenous | 1 | 60 minutes |
| sodium chloride | 0.9 % | intravenous | 1 | 120 minutes |
| filgrastim | 10 microgram/kg Once daily | subcutaneous injection | 5 to 9 |
filgrastim: Give filgrastim 10 microgram/kg subcutaneously ONCE daily from Day 5 for 4 or 5 days until stem cell harvest complete.
Full details
Cycle 1 - 14 days
Day: 1
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| mesna * | 2000 mg/m² | intravenous | 5 hours |
Instructions:
Continuous infusion over 5 hours starting ONE hour prior to CYCLOPHOSPHamide infusion until completed, or as per institutional practice. |
| sodium chloride | 0.9 % | intravenous | 120 minutes |
Quantity:1000 mL
Instructions:
Prior to CYCLOPHOSPHamide infusion. |
| CYCLOPHOSPHamide * | 2000 mg/m² | intravenous | 60 minutes |
Instructions:
Consider hydration with at least 3000 ml over 24 hours as oral or IV fluid on day(s) of CYCLOPHOSPHamide and for 24 hours after, or as per institutional practice. |
| sodium chloride | 0.9 % | intravenous | 120 minutes |
Quantity:1000 mL
Instructions:
After CYCLOPHOSPHamide infusion. |
Day: 5
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| filgrastim | 10 microgram/kg Once daily | subcutaneous injection |
Instructions:
Give ONCE daily from Day 5 until stem cell harvest complete.
|
Day: 6
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| filgrastim | 10 microgram/kg Once daily | subcutaneous injection |
Instructions:
Give ONCE daily from Day 5 until stem cell harvest complete.
|
Day: 7
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| filgrastim | 10 microgram/kg Once daily | subcutaneous injection |
Instructions:
Give ONCE daily from Day 5 until stem cell harvest complete.
|
Day: 8
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| filgrastim | 10 microgram/kg Once daily | subcutaneous injection |
Instructions:
Give ONCE daily from Day 5 until stem cell harvest complete.
|
Day: 9
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| filgrastim | 10 microgram/kg Once daily | subcutaneous injection |
Instructions:
Give ONCE daily from Day 5 until stem cell harvest complete.
|
Supportive Care Factors
| Factor | Value |
|---|---|
| Antiviral prophylaxis for herpes virus: | Routine antiviral prophylaxis recommended |
| Emetogenicity: | High |
| Hydration: | Routine hydration recommended |
| Mesna uroprotection: | Routine mesna uroprotection recommended |
Antiviral prophylaxis for hepatitis B virus: Guidance is limited to high-risk anti-cancer medicines. Clinicians will need to assess individual patient risk for other anti-cancer medicines.
References
Regimen details sometimes vary slightly from the published literature after recommendation by expert committee consensus.
* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.
s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.