Drug Index

Sargramostim

 
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Synonym :

GM-CSF

Mechanism :

Sargramostim is a colony stimulating growth factor which stimulates proliferation, differentiation, and functional activity of neutrophils, eosinophils, monocytes, and macrophages.


Indication :

• Acute myeloid leukemia (following induction chemotherapy): To shorten time to neutrophil recovery.

• Allogeneic bone marrow transplantation (myeloid reconstitution): Acceleration of myeloid reconstitution in pediatric patients 2 years of age and older.

• Allogeneic or autologous bone marrow transplantation (treatment of delayed neutrophil recovery or graft failure).

• Autologous peripheral blood progenitor cell and bone marrow transplantation.

• Hematopoietic radiation injury syndrome (acute).

• Off-label: Primary prophylaxis of neutropenia in patients receiving chemotherapy (outside transplant and AML) or who are at high risk for neutropenic fever.


Contraindications :

Hypersensitivity to human granulocyte-macrophage colony stimulating factor such as sargramostim, yeast-derived products, or any component of the formulation.


Dosing :

Use in children ≥2 years of age.

Allogeneic bone marrow transplantation (Myeloid reconstitution):

250 mcg/sqm/day IV infused over 2 hours, do not initiate until the post marrow infusion ANC is <500/mm3, and continue until ANC >1,500/mm3 for 3 consecutive days. If WBC >50,000/mm3 or ANC >20,000/mm3, interrupt treatment or reduce the dose by 50%.

Allogeneic or autologous bone marrow transplantation (treatment of delayed neutrophil recovery or graft failure):

250 mcg/sqm/day IV infused over 2 hours for 14 days.

Autologous peripheral blood progenitor cell transplantation (Myeloid reconstitution):

250 mcg/sqm/day IV infused over 24 hours. Continue until ANC is >1,500/mm3 for 3 consecutive days.

Acute hematopoietic radiation injury syndrome:

<15 kg: 12 mcg/kg SC once daily.

15 to 40 kg: 10 mcg/kg SC once daily.

>40 kg: 7 mcg/kg SC once daily.


Adverse Effect :

Hypertension, edema, pericardial effusion, malaise, headache, chills, skin changes, hyperglycemia, weight loss, hypoalbuminemia, hypomagnesemia, diarrhea, nausea, vomiting, anorexia, UTI, hyperbilirubinemia, asthenia, arthralgia, raised creatinine, fever, pharyngitis.


Interaction :

Corticosteroids: May enhance the therapeutic effect of Sargramostim.
Cyclophosphamide: May enhance the adverse/toxic effect of Sargramostim.
Lithium: Sargramostim may enhance the adverse/toxic effect of Lithium.


07/17/2019 10:28:09 Sargramostim
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