Monograph Details
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Hematology
> White blood cell disorders
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LEUKINE |
| Manufacturer |
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Bayer Corp, Pharmaceutical Div. |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Granulocyte-macrophage colony stimulating factor (recombinant). |
| Generic Name |
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Sargramostim (recombinant human granulocyte-macrophage colony stimulating factor, or rhu GM-CSF) 250micrograms; per vial; pwd for SC inj or IV infusion after reconstitution; preservative-free. |
| Indications |
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To speed neutrophil recovery and reduce infections after induction chemotherapy in treatment of acute myelogenous leukemia (AML) in patients >55 years of age. To mobilize hematopoietic progenitor cells into peripheral blood for collection by leukapheresis. To speed myeloid recovery in non-Hodgkin's lymphoma, acute lymphoblastic leukemia (ALL), and Hodgkin's disease in autologous bone marrow transplantation (BMT). To speed myeloid recovery in allogeneic BMT. Patients with BMT failure or engraftment delay. |
| Children |
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See literature. |
| Adults |
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See literature for timing and duration of dosing, and for repeat courses of therapy. Individualize. Neutrophil recovery: 250micrograms/m2 per day IV over 4 hrs. Mobilization or post peripheral blood progenitor cell transplantation: 250micrograms/m2 per day IV over 24 hrs or SC once daily. Myeloid recovery after BMT: 250micrograms/m2 per day IV over 2 hrs. BMT failure or engraftment delay: 250micrograms/m2 per day IV over 2 hrs for 14 days. |
| Contraindications |
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Excessive leukemic myeloid blasts in bone marrow or peripheral blood (≥10%). Allergy to GM-CMF or yeast-derived products. Concomitant (within 24 hrs) chemotherapy or radiotherapy. |
| Precautions |
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Fluid retention, pleural or pericardial effusions. Pulmonary infiltrates. Respiratory disease or symptoms. Hypoxia. Reduce infusion rate by ½ if dyspnea occurs; discontinue if dyspnea worsens. Cardiac disease. CHF. Renal or hepatic dysfunction (monitor before and every other week during therapy). Monitor CBC and differential twice weekly. Reduce dose by ½ or discontinue if absolute neutrophil count exceeds 20,000cells/mm3 or if platelet count exceeds 500,000cells/mm3. Myeloid malignancies. Monitor body weight and hydration. Pregnancy (Cat.C). Nursing mothers. |
| Interactions |
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Caution with lithium, corticosteroids, others that may enhance myeloproliferative effects. May be antagonized by radiotherapy, myelotoxic drugs. |
| Adverse Reactions |
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Flu-like symptoms, GI disturbances, edema, dyspnea, pharyngitis, rash, joint or bone or chest pain, eye hemorrhage, hypomagnesemia, anxiety, headache, pleural +/or pericardial effusion, arthralgia, myalgia, others. |
| How Supplied |
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Vials—5 |
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