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[Pharmacology](https://durgical.com/en/pharmacology/) · Class

# Myeloid colony-stimulating factors

Recombinant G-CSF and GM-CSF that speed neutrophil recovery after chemotherapy or a marrow transplant, lowering the risk of infection.

Updated 2026-11-01

## What they are

Filgrastim and pegfilgrastim (G-CSF) act on the neutrophil line; sargramostim (GM-CSF) acts more broadly on granulocytes and monocytes. They are used to prevent febrile neutropenia when the risk from chemotherapy is high, in severe chronic neutropenia, after stem cell transplantation and to mobilise stem cells for collection.

## Mechanism of action

They bind cytokine receptors on myeloid progenitors and, through JAK–STAT signalling, increase their proliferation, maturation and release, and activate mature neutrophils.

Target: G-CSF and GM-CSF receptors

## Key points

- Prophylaxis when the expected risk of febrile neutropenia is high; not routine treatment of established febrile neutropenia
- Bone pain is the typical adverse effect
- Rare splenic rupture: left upper abdominal or shoulder-tip pain
- Pegfilgrastim: one injection per chemotherapy cycle, given after (not during) chemotherapy
- GM-CSF causes more fever, myalgia and capillary leak than G-CSF

## Drugs in this class

- [**Filgrastim** Recombinant G-CSF that raises neutrophils and shortens neutropenia after chemotherapy, in transplants and in severe… Granulocyte colony-stimulating factor receptor (G-CSFR)](https://durgical.com/en/pharmacology/filgrastim/)
- [**Pegfilgrastim** Filgrastim joined to polyethylene glycol so it lasts longer: one injection per chemotherapy cycle to prevent febrile… Granulocyte colony-stimulating factor receptor (G-CSFR)](https://durgical.com/en/pharmacology/pegfilgrastim/)
- [**Sargramostim** Recombinant GM-CSF that stimulates granulocytes and monocytes, used to speed marrow recovery after transplantation and… GM-CSF receptor (α subunit with the common β chain)](https://durgical.com/en/pharmacology/sargramostim/)

## Others in the class

- lipegfilgrastim
- plerixafor (stem cell mobiliser, other mechanism)

## Test yourself

Think of the answer, then tap the question to see it.

## Which cell line does G-CSF mainly stimulate?

Neutrophils.

## What is the commonest adverse effect of filgrastim?

Bone pain.

## Why is pegfilgrastim not given on the day of chemotherapy?

Dividing myeloid cells stimulated by it would be more sensitive to the cytotoxic drugs.

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Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 45 (McGraw Hill, 2023); Farmacología básica y clínica (Katzung), 16.ª ed., cap. 33 (McGraw Hill, 2025); [Filgrastim Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a692033.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [eEML - Electronic Essential Medicines List](https://list.essentialmeds.org/) (World Health Organization, 2025).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/classes/myeloid-colony-stimulating-factors/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/classes/myeloid-colony-stimulating-factors/