Question

A client with leukemia is neutropenic. Which of the following drugs would the nurse expect the physician to order to treat this condition? ? A. Epoetin (Procrit) ? B. Filgrastim (Neupogen) ? C. Oprelvekin (Neumega) ? D. Porfimer sodium (Photofrin)

Short answer

Answer: B. Filgrastim (Neupogen)

Step-by-step solution

Identifying the medical condition

Neutropenia is a condition characterized by an abnormally low number of neutrophils, a type of white blood cell that plays an essential role in the immune system to fight off bacterial and fungal infections. Patients with leukemia are at risk of developing neutropenia.

Understanding the drugs and their mechanism of action

To determine the correct choice, let's briefly review the drugs and their mechanisms of action: A. Epoetin (Procrit): A drug that stimulates red blood cell production. It is commonly used to treat anemia. B. Filgrastim (Neupogen): A granulocyte colony-stimulating factor (G-CSF) that stimulates the bone marrow to produce more white blood cells, particularly neutrophils. C. Oprelvekin (Neumega): A drug that stimulates the production of platelets, which are responsible for blood clotting. D. Porfimer sodium (Photofrin): A photosensitizing agent used in photodynamic therapy to treat certain types of cancer. It is not primarily focused on treating neutropenia.

Identifying the drug that treats neutropenia

Since neutropenia is characterized by a low number of neutrophils, the most appropriate drug would be the one that focuses on increasing the production of white blood cells, particularly neutrophils. In the given options, Filgrastim (Neupogen), as a granulocyte colony-stimulating factor, is the drug explicitly designed to treat neutropenia by stimulating the production of white blood cells, including neutrophils.

Conclusion

Based on the analysis, the nurse should expect the physician to order Filgrastim (Neupogen) to treat the neutropenic condition of the leukemia patient. The correct answer is B. Filgrastim (Neupogen).

Key concepts

Leukemia management

Leukemia is a type of cancer that affects the blood and bone marrow, causing the body to produce excessive immature white blood cells. Effective leukemia management requires a multidisciplinary approach involving various treatments. Primarily, the goal is to control the progression of the disease, mitigate symptoms, and improve the patient's quality of life.
One common treatment is chemotherapy, which uses drugs to destroy cancer cells. However, it usually also affects healthy cells, which can lead to side effects, such as anemia and neutropenia. In some cases, targeted therapy may be used to specifically attack cancer cells without harming normal cells.
Another critical aspect of leukemia management is supportive care, which focuses on alleviating symptoms and preventing infections, especially given the patient's compromised immune system. Regular monitoring and blood tests are crucial to adjusting treatment plans and ensuring the best possible outcome for the patient.
Properly managing leukemia involves a combination of medical interventions and continuous support, making it a complex process that always requires personalized treatment plans, based on the patient's specific type and stage of leukemia.

White blood cell stimulation

In cases where patients suffer from neutropenia, stimulating white blood cell production is essential. Neutrophils are a crucial part of the immune response, and their deficiency makes patients vulnerable to infections. White blood cell stimulation is a therapeutic approach to increase the count of these cells in the blood.
Filgrastim, also known as Neupogen, is one of the drugs used to stimulate the production of white blood cells. This medication works by encouraging the bone marrow to produce more neutrophils. Increasing neutrophil count is vital to support the patient's immune system and help them fight infections more effectively.
Treatment typically involves regular injections, and the dosage may be adjusted based on the patient's response. It's important to monitor the patient's white blood cell count to ensure alignment with therapeutic goals.

• This treatment aids in reducing the duration of neutropenia
• Helps in lowering the risk of infections
• Contributes to an overall improvement in patient outcomes

Thus, white blood cell stimulation plays a crucial role in the effective management of neutropenia associated with conditions like leukemia.

Granulocyte colony-stimulating factor

Granulocyte colony-stimulating factor (G-CSF) is a protein that plays a critical role in hematopoiesis, which is the process of blood cell production. G-CSF primarily influences the production and function of neutrophils, a type of white blood cell vital for fighting infections.
The administration of G-CSF is particularly beneficial for cancer patients, including those undergoing chemotherapy, which often results in low neutrophil levels. By using G-CSF agents like Filgrastim, doctors can stimulate the bone marrow and accelerate neutrophil recovery, thus reducing infection risks.
Apart from its role in treating chemotherapy-induced neutropenia, G-CSF is also used to prepare patients for stem cell transplants. It mobilizes stem cells from the bone marrow to the bloodstream, making collection easier for transplantation procedures.
The benefits of using G-CSF include:

• Enhanced recovery of neutrophil counts
• Shortened duration of neutropenic periods
• Decreased dependency on antibiotics and reduced hospitalization time

In summary, G-CSF represents a significant advancement in treating neutropenia, enhancing patient care by promoting immune function and reducing complications associated with low white blood cell counts.