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granulocyte-macrophage colony-stimulating factor produced by recombinant technology; used to enhance neutrophil function, stimulating hematopoiesis and decreasing neutropenia; administered intravenously or subcutaneously.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.

sargramostim (GM-CSF)


Pharmacologic class: Granulocytemacrophage colony stimulating factor

Therapeutic class: Hematopoietic agent

Pregnancy risk category C


Stimulates proliferation and differentiation of hematopoietic cells that activate mature granulocytes and macrophages of target cells


Liquid: 500 mcg/ml

Powder for injection: 250 mcg

Indications and dosages

Post peripheral blood progenitor cell (PBPC) transplantation

Adults: 250 mcg/m2/day I.V. over 24 hours or subcutaneously once daily, starting immediately after progenitor cell infusion

Mobilization of PBPCs into peripheral blood for collection by leukapheresis

Adults: 250 mcg/m2/day I.V. over 24 hours or subcutaneously once daily, continued throughout harvesting

Neutrophil recovery after chemotherapy in acute myelogenous leukemia Adults: 250 mcg/m2/day I.V. over 4 hours, starting 4 days after completion of chemotherapy induction

Bone-marrow transplantation failure or engraftment delay

Adults: 250 mcg/m2/day as 2-hour I.V. infusion for 14 days. If engraftment doesn't occur, may repeat after 7 days of drug hiatus.

Myeloid reconstitution after autologous or allogeneic bone-marrow transplantation

Adults: 250 mcg/m2/day as a 2-hour I.V. infusion, starting 2 to 4 hours after autologous bone marrow infusion and at least 24 hours after last chemotherapy or radiotherapy dose

Off-label uses

• Crohn's disease

• Melanoma

• Wound healing

• Mucositis

• Stomatitis

• Vaccine adjuvant


• Hypersensitivity to drug, its components, or yeast products

• Excessive leukemic myeloid blasts in bone marrow or peripheral blood (10% or more)

• Within 24 hours before or after chemotherapy or radiation therapy


Use cautiously in:

• renal or hepatic insufficiency, fluid retention, pulmonary disorders, pulmonary infiltrates, heart failure, leukocytosis, transient supraventricular arrhythmias

• cancer patients undergoing sargramostim-mobilized PBPC collection

• patients receiving purged bone marrow or previously exposed to intensive chemotherapy or radiation therapy

• pregnant or breastfeeding patients

• children.


Don't give within 24 hours of chemotherapy or radiation therapy.

• Add 1 ml of sterile water to powder for injection by directing water stream against side of vial and swirling vial gently to disperse contents.

• Avoid shaking or agitating solution.

• For a final drug concentration below 10 mcg/ml, add human albumin 0.1% to saline solution; then dilute drug in normal saline solution.

• Infuse as soon as possible after reconstitution, but no more than 6 hours after mixing.

• Don't add other drugs to infusion; don't use in-line filter.

Adverse reactions

CNS: malaise, asthenia

CV: peripheral edema, tachycardia, hypotension, transient supraventricular tachycardia, pericardial effusion

GI: nausea, vomiting, diarrhea, anorexia, stomatitis, GI hemorrhage

GU: urinary tract disorder, abnormal renal function

Hematologic: blood dyscrasias, hemorrhage

Hepatic: hepatic damage

Musculoskeletal: joint pain, myalgia, bone pain

Respiratory: dyspnea, lung disorder

Skin: rash, alopecia

Other: fever, chills, sepsis, edema, first-dose reaction (respiratory distress, hypoxia, syncope, tachycardia, hypotension, flushing)


Drug-drug. Corticosteroids, lithium: potentiation of myeloproliferative effects

Vincristine: severe peripheral neuropathy

Patient monitoring

• Monitor for dyspnea. Halve dosage and contact prescriber if dyspnea occurs.

• Assess CBC with white cell differential. Check for presence of blast cells, and watch for signs and symptoms of blood dyscrasias.

• Closely monitor vital signs and fluid intake and output. Stay alert for signs and symptoms of fluid overload.

Monitor liver function tests, and watch for evidence of hepatic damage and bleeding (especially GI hemorrhage).

Patient teaching

Tell patient sargramostim is a powerful drug that can cause significant adverse reactions. Teach him to recognize and report serious reactions at once.

Instruct patient to immediately report unusual bleeding or bruising or yellowing of skin or eyes.

• Tell patient drug may cause weakness and musculoskeletal pain.

• Inform patient that he'll undergo regular blood testing during therapy.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs mentioned above.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved


A recombinant human granulocyte-macrophage colony-stimulating factor (GM-CSF); used to reduce the duration of neutropenia and incidence of infection in patients receiving myelosuppressive chemotherapy or bone marrow transplantation.
Farlex Partner Medical Dictionary © Farlex 2012


A gene on chromosome 5q23-q31 that encodes colony stimulating factor 2 (granulocyte-macrophage), a cytokine that controls the production, differentiation and function of granulocytes and macrophages.

Molecular pathology
CSF2 is localised to a cluster of related genes at chromosome 5q31, a region associated with deletions in the 5q- syndrome and acute myelogenous leukaemia.
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved.


Recombinant GM-CSF Immunology A biological response modifier that accelerates myeloid recovery in Pts with lymphomas and ALL with BM suppression by chemotherapy and/or RT Side effects Rash, diarrhea, asthenia, malaise. See G-CSF, GM-CSF. Cf Pseudo-orphan drug.
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.


A recombinant human granulocyte-macrophage colony-stimulating factor; used to protect against infection in the presence of acute myelogenous leukemia and in bone marrow transplants.
Medical Dictionary for the Health Professions and Nursing © Farlex 2012


A granulocyte-macrophage colony-stimulating factor. Sargramostim is a haematopoietic growth factor that stimulates cells of the intestinal immune system.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005


A medication made from yeast that stimulates WBC production. It is sold under the trade names Leukine and Prokine.
Mentioned in: Neutropenia
Gale Encyclopedia of Medicine. Copyright 2008 The Gale Group, Inc. All rights reserved.
References in periodicals archive ?
In view of the preliminary data, we proposed a pilot study to evaluate the safety and efficacy of sargramostim in CD patients with fistulizing disease who had not responded to conventional therapy (antibiotics, oral glucocorticoids, infliximab, azathioprine, 6-mercaptopurine, methotrexate, or tacrolimus) or who had developed adverse events to infliximab requiring discontinuation of the drug.
They were randomized 2:1 to sargramostim (Leukine)--a granulocyte-macrophage, colony-stimulating factor--at 6 mcg/kg per day subcutaneously, or to placebo for 8 weeks.
"In addition to reducing disease severity scores, sargramostim appears to significantly improve quality of life," as measured with both the Inflammatory Bowel Disease Questionnaire (IBDQ) and the Short Form-36, Joshua R.
Cancer biotech company Partner Therapeutics Inc reported on Wednesday the receipt of the US FDA's approval for Leukine (sargramostim) for the treatment of adult and pediatric patients acutely exposed to myelosuppressive doses of radiation (Hematopoietic Syndrome of Acute Radiation Syndrome, or H-ARS).
(PTx) has acquired the global rights to develop, manufacture, and commercialise immuno-stimulant Leukine (sargramostim) from France-based pharmaceutical firm Sanofi (NYSE: SNY), the company said.
(12, 34-37) This involves in-depth immune profile blood testing and when indicated, precise administration of expensive drugs like interleukin-2, (12,38-46) filgrastim (Neupogen[R]), (47,48) pegfilgrastim (Neulasta[R]), (49-58) and/or sargramostim (Leukine[R]).
Niaz presented data from a study that quoted that 95% of a set of patients showed immune response to leukine (active ingredient: sargramostim), whereas there were some others that elicited far less immunogenicity; for example, Avonex (active gradient: interferon beta-1a); 6%, and Neupogen (active ingredient: filgrastim), zero (0%).
Sequential administration of GM-CSF (Sargramostim) and IL-2 [+ or -] autologous vaccine as adjuvant therapy in cutaneous melanoma: An interim report of a phase II clinical trial.
Your doctor should also prescribe medications such as filgrastim (Neupogen), pegfilgrastim (Neulasta) or sargramostim (Leukine) between chemotherapy cycles to quickly restore reduced white blood cell counts to normal levels to help prevent infection.
Waller, "The role of sargramostim (rhGM-CSF) as immunotherapy," Oncologist, vol.