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The Leukemia/Bone Marrow Transplant Program of BC

Autologous Transplant
Peripheral Blood
Stem Cell Collection
G-CSF Administration

Vein Assessment The Collection Process
G-CSF Administration Important Reminders
When to Call the Doctor  

Frequently Asked Questions - FAQs

What is G-CSF?

G-CSF is a colony stimulating factor. Colony stimulating factors are naturally occurring special proteins in the human body that stimulate blood cell production and growth. G-CSF helps increase the number of stem cells in your blood stream.

These naturally occurring proteins can also be manufactured as a drug. The G-CSF used in our Program is Neupogen®. The generic name is filgrastim.

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Why is G-CSF given?

In order to limit the number of times you have to undergo stem cell collection, the BMT doctor will try to move your stem cells out of your bone marrow and into your blood stream. This process is called mobilization. The G-CSF you will receive will encourage the growth of stem cells in your body and mobilize them into your blood stream for collection.

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How will it help my transplant?

Engraftment is the process by which re-infused stem cells grow in the bone marrow and manufacture new blood cells. After your stem cells are re-infused, engraftment is the indication that the new stem cells are working properly. Research has shown that stem cells that have been mobilized engraft faster than stem cells collected directly from the bone marrow.

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How much does G-CSF (Neupogen®) cost?

G-CSF is a very expensive prescription medication and is NOT paid for by the Vancouver General Hospital or the BC Cancer Agency for the autologous transplant patient. Unfortunately, this is the only medication that can be used to increase blood stem cells.  Generally, the cost of G-CSF for one course of treatment will be between $3000.00 and $3800.00.

Here is what you need to know:

  1. You should be registered for BC Fair PharmaCare. You can contact Fair PharmaCare (1-800-663-7100) to clarify your benefit plan and medication coverage. If you have already reached your deductible amount with Fair PharmaCare, in the present calendar year, the cost of your G-CSF may be greatly reduced.
  2. Depending on your extended health plan and your Fair PharmaCare deductible, you will need to pay for some or this entire amount “out-of-pocket”. 
  3. You may have drug cost reimbursement through an extended health plan or funding from social assistance (Ministry of Human Resources). You should contact the insurance carrier or your financial aid worker to discuss coverage of this medication.
  4. If you have tried all the above and still cannot afford the medication, please contact the Leukemia/BMT Program Coordinator or the Social Worker assigned to you, to discuss this situation further.

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How is G-CSF given?

G-CSF will be administered daily by injection, through a tiny needle under the skin. Arrangements will be made for you to receive your injections either in the Cell Separator Unit, the BMT Day Care Unit or if you prefer you may arrange to have them given at your family doctor’s office or walk-in clinic near your home. 

Generally, you will take G-CSF for 5 days. Stem cell collection will commence on the 4th day. On the 5th day you will have an early appointment to come to the Cell Separator Unit (CSU) and have your blood drawn in order to check your blood counts. Assuming your neutrophil count is sufficiently high, you will proceed to have your peripheral stem cells collected. If your counts are not elevated enough, you may be prescribed additional days of G-CSF therapy.

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What should I expect when injecting G-CSF?

When G-CSF is injected, you may feel a slight stinging sensation at the injection site. Sometimes, injecting into a larger surface area such as the abdomen or injecting the medication slower can reduce the stinging. If you experience some pain or redness at the injection site, it should go away soon. If it does not, contact your nurse or doctor.

Sometimes a “bump” occurs at the injection site. Do not rub it. The bump will often go away within a few hours. If the bump persists for more than a few hours, contact your nurse or doctor.

A small amount of medication can sometimes leak out at the injection site when the needle is withdrawn. If it does, simply apply light pressure with the alcohol swab, but do not rub.

Other drugs may interact with G-CSF. It is important that you tell your doctor if you are taking any other medicines. This includes, over-the-counter drugs, naturopath/herbal remedies, including vitamins, teas, etc. Inform your doctor even if you only take these occasionally.

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What are the side effects of G-CSF?

Generally, G-CSF is well tolerated. Some patients have experienced discomfort that is usually reported as headache and/or aching in the bones, most often in the back and hips. If you feel discomfort, please contact your doctor or nurse for advice on how best to relieve it. Be sure to tell your nurse or doctor if you experience any symptoms that concern you while you are taking G-CSF. Never take a medication for a side effect, or for anything else, unless your nurse or doctor recommends it.

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