Description
Sargramostim, a recombinant DNA product, is a granulocyte macrophage colony
stimulating factor (GM-CSF) indicated for the treatment of cancer patients after
autologous bone marrow transplants. It stimulates immature cells to develop into
granulocytes and macrophages and can also switch on mature granulocytes and
macrophages.Other indications include improved bone m m w recovery in
non-Hodgkins lymphoma and acute lymphoblastic leukemia.
Originator
Immunex (U.S.A.)
Uses
Antineutropenic; hematopoietic stimulant.
Indications
Sargramostim (GM-CSF, Leukine, Prokine) is a human
recombinant granulocyte and macrophage colony–
stimulating factor that stimulates the production and potentiates
the function of both granulocytes and macrophages
from hematopoietic progenitor cells. It is used to
accelerate bone marrow repopulation after high-dose
chemotherapy, radiation therapy, and bone marrow transplantation.
Adverse effects associated with sargramostim
use include bone pain (similar to that of filgrastim), fatigue,
fevers, skin rash, malaise, and fluid retention.
brand name
Leukine (Immunex);Prokine.
General Description
Sargramostim, rGM-CSF (Leukine), isa glycoprotein commercially produced in genetically engineeredyeast cells. Its polypeptide chain contains 127 aminoacids. It differs from the natural hormone by substitution ofleucine at position 23 and variations in the glycosylation.94Sargramostim is a lineage-nonspecific hematopoietic factor,because it promotes the proliferation and maturation ofgranulocytes (neutrophils and eosinophils) and monocytes(macrophages and megakaryocytes).
The primary indication for sargramostim is in myeloidengraftment following autologous bone marrow transplantationand hematopoietic stem cell transplantation. Handling,storage precautions, and adverse effects are similar to thosefor filgrastim.
Clinical Use
Sargramostim binds to specific receptors on target cellsand induces proliferation, activation, and maturation.Administration to patients causes a dose-related increase inthe peripheral white blood cell count. Unlike G-CSF, GMCSFis a multilineage hematopoietic growth factor that inducespartially committed progenitor cells to proliferate anddifferentiate along the granulocyte and the macrophage pathways.It also enhances the function of mature granulocytesand macrophages/monocytes. GM-CSF increases the chemotactic,antifungal, and antiparasitic activities of granulocytesand monocytes. It also increases the cytotoxicity of monocytestoward neoplastic cell lines and activates polymorphonuclearleukocytes to inhibit the growth of tumor cells.
Sargramostim is used to reconstitute the myeloid tissueafter autologous bone marrow transplant and followingchemotherapy in acute myelogenous leukemia. The preparationdecreases the incidence of infection, decreases the numberof days that antibiotics are required, and decreases theduration of hospital stays.
