Pegfilgrastim (Neulasta)

Long-acting G-CSF (granulocyte colony-stimulating factor) used to support neutrophil recovery during Aml treatment with Azacitidine + Venetoclax.

Clinical Course

Pegfilgrastim was administered during Cycle 3 of Aza-Ven (started 2026-03-02) to address neutropenia.

Adverse Reaction

The patient experienced significant bone pain following pegfilgrastim administration. This is a known common side effect of G-CSF agents (occurs in ~30% of patients) caused by bone marrow stimulation.

Discontinuation

On 2026-03-30, Dr. Bijay Prabhakaran Nair documented that pegfilgrastim would be avoided going forward due to the pain experienced. Cycle 4+ and subsequent cycles proceeded without G-CSF support.

[!info] Source
WhatsApp message from Dr. Bijay P (Oncologist) to Sameer, 2026-03-30: "Looks like she had significant pain with pegfilgrastim. So will avoid this time."

Sameer's response confirmed the plan: "Let's see how the numbers are without G-CSF."

Monitoring Without G-CSF

Without pegfilgrastim, CBC monitoring becomes even more critical during nadir periods (typically days 10–14 of each cycle). ANC should be tracked closely for prolonged or severe neutropenia.

Created from WhatsApp correspondence ingest.