Ryzneuta — Medical Mutual

Prophylactic use in patients with non-myeloid malignancy undergoing myelosuppressive chemotherapy

Initial criteria

Patient age ≥ 18 years
Will not be used for the mobilization of peripheral blood progenitor cells for hematopoietic stem cell transplantation
No history of serious allergic reactions to granulocyte stimulating factor products (e.g., pegfilgrastim, filgrastim, etc.)
Patient is undergoing myelosuppressive chemotherapy with an expected incidence of febrile neutropenia >20%; OR
Patient is undergoing myelosuppressive chemotherapy with an expected incidence of febrile neutropenia of 10% to 20% AND at least one of the following:
Age >65 years receiving full dose intensity chemotherapy
Extensive prior exposure to chemotherapy
Previous exposure of pelvis or other areas of large amounts of bone marrow to radiation
Pre-existing neutropenia (ANC ≤ 1000/mm3)
Bone marrow involvement with tumor
Condition that can potentially increase the risk of serious infection (i.e., HIV/AIDS with low CD4 counts)
Recent surgery and/or open wounds
Poor performance status
Renal dysfunction (creatinine clearance <50 mL/min)
Liver dysfunction (elevated bilirubin >2.0 mg/dL)
Chronic immunosuppression in the post-transplant setting including organ transplant

Patient continues to meet indication-specific relevant criteria (such as concomitant therapy requirements and performance status)
Absence of unacceptable toxicity from the drug (e.g., splenic enlargement/rupture, acute respiratory distress syndrome, severe hypersensitivity reactions/anaphylaxis, severe sickle cell crises, glomerulonephritis, hematologic effects, capillary leak syndrome, tumor cell mobilization, MDS/AML in breast and lung cancer patients, aortitis)

4 months