Granulocyte Macrophage Colony Stimulating Factor
Synonym :
GM-CSF
Mechanism :
Granulocyte-macrophage colony-stimulating factor, often abbreviated to GM-CSF, is a protein secreted by macrophages, T cells, mast cells, endothelial cells and fibroblasts. GM-CSF is a cytokine that functions as a white blood cell growth factor. GM-CSF stimulates stem cells to produce granulocytes (neutrophils, eosinophils, and basophils) and monocytes.
Indication :
- Bone marrow transplant (myeloid recovery)
- Acute radiation syndrome
Contraindications :
Contraindicated in myeloid malignancy. Monitor FBC closely.
Dosing :
Acute radiation syndrome:
Under 15 kg:
12 mcg/kg subcutaneously once every day.
15-40 kg:
10 mcg/kg subcutaneously once every day.
Over 40 kg:
7 mcg/kg subcutaneously once every day.
Autologous Bone Marrow Transplantation/Autologous peripheral Blood progenitor cell transplantation:
Under 2 years:
Safety and efficacy not established.
Above 2 years:
250 mcg/m²/day intravenously over one day or subcutaneously every day; Continue till ANC >1500 cells/cumm for 3 consecutive days.
Adverse Effect :
Bone pain, anorexia, flushing, allergic reactions, malaise, lethargy, skin rashes, fever and chills. At high doses, weight gain is often seen along with breathing difficulties, blood clots and pleural effusion and pericardial effusion.
Interaction :
Lithium: Drugs which may potentiate the release of neutrophils, such as lithium, should be used with caution.
Hepatic Dose :
No data available regarding dosage adjustment.