Updated: 4/14/2020

Filgrastim / Sargramostim

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Snapshot
  • A 45-year-old woman undergoing chemotherapy for breast cancer undergoes routine laboratory work-up. A complete blood count is significant for neutropenia and anemia. She has been on filgrastim for chemotherapy-related neutropenia. She follows up with her medical oncologist, who suggests switching to sargramostim, which works in a slightly different mechanism.
Introduction
  • Drugs
    • filgrastim
      • recombinant human granulocyte-colony stimulating factor (G-CSF)
    • pegfilgrastim
      • recombinant PEG-conjugated human G-CSF
    • sargramostim
      • recombinant granulocyte macrophage CSF (GM-CSF)
  • Mechanism of action
    • G-CSF
      • stimulates production of neutrophils
    • GM-CSF
      • stimulates production of neutrophils, dendritic cells, and monocytes/macrophages
  • Clinical use
    • neutropenia
      • myelosuppressive chemotherapy
      • aplastic anemia
      • congenital neutropenia
    • stem cell transplantation
  • Adverse effects
    • nausea and vomiting
    • bone pain
    • cutaneous vasculitis
    • allergic reaction
      • angioedema
      • urticaria
      • anaphylaxis
    • thrombocytopenia
    • capillary leak syndrome
    • leukocytosis

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