The Use of Neupogen (Filgrastim) or Neulasta (Pegfilgrastim) during Pregnancy When Chemotherapy Is Indicated for Maternal Cancer Treatment


Introduction: Little is known about the effects stem cell mobilizers (GCSF) such as neulasta (pegfilgrastim) or neupogen (filgrastim) during pregnancy, and these are often withheld from women undergoing chemotherapy during pregnancy. Materials and Methods: Women receiving chemotherapy during pregnancy were identified from the Cancer and Pregnancy Registry maintained at Cooper University Hospital, Cooper Medical School at Rowan. 176 pregnant women who received chemotherapy were identified. Their oncologists were asked if neupogen or neulasta were “prescribed when necessary;” “were not necessary;” or “were held due to pregnancy.” Birth outcomes, white blood count at birth and pediatric health were compared between the group receiving Neupogen/Neulasta (exposed) and a control group (unexposed), i.e. chemotherapy without neupogen/neulasta). Independent T Test or Pearson Chi Square were implemented for statistical comparisons. Results: The mean gestational age at delivery was not significantly different between the exposed (35.4 ± 2.8 weeks) and unexposed groups (35.9 ± 2.8 weeks) p = 0.465. The mean birth weights were not significantly different, 2433 ± 567 g (exposed) compared with 2673 ± 723g in unexposed group, p = 0.07. Nor was there a difference in congenital malformations: 11.7% versus 4.8%. p = 0.22. The incidence of non-iatrogenic preterm births or complications was not statistically different between groups. Mean WBC count in the exposed group was 13.04 ± 5.0 cells per cubic millimeter of blood and in the unexposed group was 14.6 ± 7.2, p = 0.24. Conclusion: We did not find a statistically significant difference in gestational age at birth, congenital anomalies, or birth weight, incidence of long term medical issues, mean WBC or neutropenia at birth between the newborns exposed to Neupogen/ Neulasta with chemotherapy and newborns exposed to chemotherapy alone.

Share and Cite:

E. Cardonick, F. Irfan and N. Torres, "The Use of Neupogen (Filgrastim) or Neulasta (Pegfilgrastim) during Pregnancy When Chemotherapy Is Indicated for Maternal Cancer Treatment," Journal of Cancer Therapy, Vol. 3 No. 2, 2012, pp. 157-161. doi: 10.4236/jct.2012.32021.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] A. Aviles, J. C. Diaz-Maqueo, A. Talavera, R. Guzman and E. L. Garcia, “Growth and Development of Children of Mothers Treated with Chemotherapy during Pregnancy: Current Status of 43 Children,” American Journal of Hematology, Vol. 36, No. 4, 1991, pp. 243-248. doi:10.1002/ajh.2830360404
[2] D. L. Berry, R. L. Theriault, F. A. Holmes, V. M. Parisi, D. J. Booser, S. E. Singletary, et al., “Management of Breast Cancer during Pregnancy Using a Standardized Protocol,” Journal of Clinical Oncology, Vol. 17, No. 3, 1999, pp. 855-861.
[3] R. C. Doll, Q. S. Ringenberg and J. W. Yarbo, “Antineoplastic Agents and Pregnancy,” Seminars in Oncology, Vol. 16, 1989, pp. 337-345.
[4] E. Cardonick and A. Iacobucci, “Use of Chemotherapy during Human Pregnancy,” Lancet Oncology, Vol. 5, 2004, pp. 263-291. doi:10.1016/S1470-2045(04)01466-4
[5] D. A. Calhoun, C. Rosa and R. D. Christensen, “Transplacental Passage of Recombinant Human Granulocyte Colony-Stimulating Factor in Women with an Imminent Preterm Delivery,” American Journal of Obstetrics & Gynecology, Vol. 174, No. 4, 1996, pp. 1306-1311. doi:10.1016/S0002-9378(96)70676-2
[6] R. Fujiwaki, T. Hata, K. Hata, M. Kitao, H. Furuya and Y. Katoh, “Effective Treatment of Drug-Induced Agranulocytosis Using Recombinant Human Granulocyte Colony Stimulating Factor in Pregnancy,” Gynecologic and Obstetric Investigation, Vol. 40, No. 4, 1995, pp. 276-277. doi:10.1159/000292355
[7] H. A. Arango, C. S. Kalter, S. L. Decesare, J. V. Fiorica, G. H. Lyman and W. N. Spellacy, “Management of Chemotherapy in a Pregnancy Complicated by a Large Neuroblastoma,” Obstetrics & Gynecology, Vol. 84, No. 4, Part 2, 1994, pp. 665-668.
[8] S. J. Kaufmann, K. Sharif, V. Sharma and B. A. McVerry, “Term Delivery in a Woman with Severe Congenital Neutropenia, Treated with Growth Colony Stimulating Factor,” Human Reproduction, Vol. 13, No. 2, 1998, pp. 498-499. doi:10.1093/humrep/13.2.498
[9] T. Abe, H. Azuma, A. Watanabe, T. Shigekiyo, S. Endou, R. Pou, R. Fukui, K. Maeda, T. Aono and T. Matsumoto, “A Patient with Cyclic Neutropenia Complicated by Severe Persistent Neutropenia Successfully Delivered a Healthy Baby,” Internal Medicine, Vol. 39, No. 8, 2000, pp. 663-666. doi:10.2169/internalmedicine.39.663
[10] M. R. Sangalli, M. Peek and A. McDonald, “Prophylactic Granulocyte Colony-Stimulating Factor Treatment for Acquired Chronic Severe Neutropenia in Pregnancy,” Australian and New Zealand Journal of Obstetrics and Gynaecology, Vol. 41, No. 4, 2001, p. 470.
[11] M. Kikkawa, S. Matsubara, M. Takatoku, T. Kuwata, A. Ohkuchi, A. Izumi, T. Watanabe, M. Suzuki, “Granulocyte-Colony Stimulating Factor for the Treatment of Ritodrine-Induced Neutropenia,” Journal of Obstetrics and Gynaecology Research, Vol. 34, No. 2, 2008, pp. 286-290. doi:10.1111/j.1447-0756.2008.00773.x
[12] D. M. Niedermeier, D. A. Frei-Lahr and P. D. Hall, “Treatment of Acute Myeloid Leukemia during the Second and Third Trimesters of Pregnancy,” Pharmacotherapy, Vol. 25, No. 8, 2005, pp. 1134-1140. doi:10.1592/phco.2005.25.8.1134
[13] T. Ohba, T. Yoshimura, M. Araki, J. Miyoshi, Y. Yonemura, K. Matsuura and H. Okamura, “Aplastic Anemia in Pregnancy: Treatment with Cyclosporine and Granulocyte-Colony Stimulating Factor,” Acta Obstetricia et Gynecologica Scandinavica, Vol. 78, No. 5, 1999, pp. 458-461.
[14] G. Leitner, H. Loidolt, H. T. Greinix, P. Hocker and M. Dettke, “Granulocyte Colony Stimulating Factor-Induced Allogenic Peripheral Stem Cell Donation during Early Pregnancy,” British Journal of Haematology, Vol. 115, No. 1, 2001, pp. 233-234.
[15] T. E. Cottle, C. J. Fier, J. Donadieu and S. E. Kinsey, “Risk and Benefit of Treatment of Severe Chronic Neutropenia with Granulocyte Colony-Stimulating Factor,” Seminars in Hematology, Vol. 39, No. 2, 2002, pp. 134-140. doi:10.1053/shem.2002.31914

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.