Nivestym

Monitor blood, including CBC and differential and platelets, before and during therapy (myelosuppressive chemotherapy: monitor twice weekly; BMT: monitor frequently following transplantation; SCN: monitor during initial 4 weeks of therapy and during 2 weeks after dose adjustment, then monthly once clinically stable). Discontinue if post nadir absolute neutrophil count (ANC) >10,000/mm³ for patients receiving myelosuppressive chemotherapy; other indications: see full labeling. Monitor for splenomegaly/splenic rupture and for acute respiratory distress syndrome (ARDS); discontinue if ARDS develops. Confirm diagnosis and do appropriate pretreatment hematological workup in SCN. Sickle cell disease: may cause severe sickle cell crisis (discontinue if occurs). Consider reducing or interrupting dose if glomerulonephritis suspected. Monitor for MDS/AML in those with severe chronic neutropenia, breast or lung cancer. Monitor for aortitis; discontinue if suspected. Avoid simultaneous chemo- and radiation therapy. Withhold therapy if cutaneous vasculitis occurs; resume at lower dose when resolved. Permanently discontinue if serious allergic reactions occur. PBPC mobilization: not for use in healthy donors. Possible transient (+) bone imaging changes in nuclear imaging. Pregnancy. Nursing mothers.