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Updated: Apr 14 2020

Filgrastim / Sargramostim

  • 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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