Question

• Greg Stevens is a 56-year-old client who has been diagnosed with Hodgkin’s disease. He has completed a course of antineoplastic chemotherapy and is currently hospitalized for a bone marrow transplant. His medical history includes mild chronic renal insufficiency. He also has a history of coronary artery disease: he had coronary angiography 1 year ago. This study revealed a 90% blockage in one vessel, which was opened with angioplasty and stents. Blockages of 50% to 60% in two other coronary arteries were not treated at that time. Mr. Stevens has just completed the bone marrow infusion, and the nurse is preparing to administer a colony-stimulating factor (CSF). Which of the colony-stimulating factor drugs might provide an additional benefit to Mr. Stevens in view of his cardiac history?
• a.Stevens questions the need for the CSF, stating, “I have new bone marrow now. Won’t that make all the bone cells I need?” How should the nurse respond?b. Stevens asks how long the CSF infusion will take. Discuss the timing of the infusion and length of therapy with CSF agents. What laboratory tests should be monitored during therapy?

Answer 1

a. You're most likely to get one during the first 6 weeks. After that, your new stem cells will probably start making white blood cells that can help your body defend itself. But it can take up to a year for your immune system to fully recover.

G-CSF therapy was initiated between days 2 and 5 after stem-cell infusion at a dose of 5 mcg/kg once daily, rounded to the nearest vial size (300 mcg or 480 mcg), and therapy was continued until neutrophil engraftment. IV filgrastim was diluted in dextrose 5% to a concentration of 15 mcg/mL and given as a bolus injection through a central venous catheter over 15 to 30 minutes. Patients were assigned to each group according to the route of administration (SQ or IV) for >50% of administrations CSF can be administered safely in patients as an intravenous (IV) infusion or subcutaneous (SQ) injection.

You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.