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G-CSF administration - a step by step guide

If you’re donating your stem cells through the PBSC method, in the four days leading up to your donation day you’ll need to have injections of a growth factor known as ‘G-CSF’.

Administering G-CSF injections

The G-CSF injections are to boost your white cell count and release stem cells into the bloodstream ready to collect. 

You can read more about how they work and the side-effects you might experience on our guide to G-CSF injections page.

If you or a family member/friend is administering the injections, below is a step-to-step-guide on how to do it and what to expect.

Will I have ongoing support? 

Yes! You can contact someone at Anthony Nolan at any point – during office hours call 020 7424 6699 or before 9am/after 5pm/at the weekend call 07710 599161. If you have any doubts about you or your family member/friend administering the G-CSF please let your Anthony Nolan coordinator know as early as possible before your injections are due to start so we can support you.

Key things to know

  • You will need a family member/friend to be with you the FIRST time you administer the G-CSF injections and they must be able to stay with you on for at least an hour after the injection/s on day 1. If they are administering for you they will need to be available at the same time each day to give you the injection/s over the full four days.  
  • You must only start your G-CSF injections on day 1 if you are feeling well and, if you have been asked to do so, have completed a urine pregnancy test and got a negative result. Please contact Anthony Nolan on 07710 599161 if you feel unwell or if you get a positive pregnancy test.
  • Try to have the injections at the same time each day as this will reduce the side effects and help produce more stem cells. We recommend doing it in the evening if possible so that your last injections are closer to the start of your donation, and also so you may sleep through any side effects, but this is not essential.
  • G-CSF is given subcutaneously, i.e. just under the skin in a fleshy part of your body such as the abdomen, thigh or arm. If you’re administering the injections yourself, it’s often easiest to use your abdomen as it’s easy to pinch a bit of flesh with one hand and give the injection with the other.
  • The G-CSF medication is pre-filled syringes which will be couriered to your home address usually between 3-7 days before the first date of your injections. The medication should remain in its outer packaging to protect it from light and must be kept in the fridge (2°C - 8°C) until it is required for use. Once it is taken out of the fridge it can be stored at room temperature for up to 8 days until used.
  • A sharps bin will be delivered along with the pre-filled syringes, this will be collected 7 - 14 days after your donation. The nursing company will be in touch about collecting this bin but if there are any issues let your Anthony Nolan coordinator know. 
GCSF instructions icon

I had a friend with me when I administered the G-CSF which helped to give me the confidence to inject. It's nice to have someone present for encouragement and to share that experience with you. 

Your step by step guide

  • You must have someone with you for your first time injecting yourself and make sure they can stay with you for at least an hour after your injection/s.
  • Collect your equipment: Zarzio injections, sharps bin and a clean tissue/cotton pad.
  • Take your injection/s out of the fridge a minimum of 30 minutes before giving them.
  • Check the dose you should take each day, and that you have got the right dose ready to inject. Also check the expiry date on the injection/s is within date.
  • If you have 2 injections that are different doses, it doesn’t matter in which order they are given.
  • Wash your hands with soap and water. You can also use alcohol gel.
  • Select the area of your abdomen (or thigh, arm) you wish to inject. Rotate the areas you are injecting for each injection so that one area does not become too sore and allows time for recovery. Ensure the skin is clean and dry.
  • Gently pinch or grasp a skin fold with your non-dominant hand. This is to avoid injecting into deeper tissue such as the muscle.
  • Fully insert the needle in a quick, firm action with your dominant hand at a 45 – 90-degree angle.
  • Slowly push the syringe plunger over 10-30 seconds until all the dose is given and you can push no more.
  • Remove the needle while maintaining pressure on the plunger. You will hear the click of the needle safety guard rapidly moving to cover the needle. This is to prevent accidental injury from the needle.
  • Release the pinched skin and put the whole Zarzio injection into the sharps bin.
  • Pat the site with clean tissue or cotton pad if there is a spot of blood or fluid. Don’t rub or massage the area after injecting as this can cause increased bruising and speed up absorption times of the drug.
  • When ready, repeat until full dosage for the day is given.
  • Wash your hands again and place your sharps bin somewhere safe, out of reach of small children.
  • Congratulate yourself or your family member/friend at doing an amazing job and do the same again on days 2, 3 and 4.

I just followed the instructions to the letter. Injecting the three needles took no longer than five minutes! Such an easy process, I am actually shocked at how pain-free it is.

What do donors say?

We’ve found that donors who choose to administer the injections feel really positive about it and appreciate the independence and convenience. Although some felt a bit nervous doing it, their nurse’s support helped guide them.