Mechanism of Actionneptuneweb2023-10-20T14:45:39-04:00

LEUKINE® (sargramostim) activates multilineage immune defense against infection¹

LEUKINE is the first and only FDA-approved GM-CSF that supports the survival, growth, and activation of neutrophils, monocytes/macrophages, and myeloid-derived dendritic cells¹

Explore the hematopoietic cascade by clicking on the cell types below:

Multipotent hematopoietic stem cell^2-5*

Multipotent hematopoietic cascade diagram

Macrophage Neutrophil Dendritic Cell

Macrophage Neutrophil Dendritic Cell

*This image is a partial representation of the hematopoietic cascade. It does not include all cytokines necessary for hematopoiesis.

Neutrophil

neutrophil

Neutrophil: first responder

Neutrophils are the first line of immune defense against invading pathogens, including bacteria, fungi, and protozoa⁷
They phagocytize and destroy pathogens and enhance the anti-infection response of immune cells such as dendritic cells, lymphocytes, and natural killer cells⁷
GM-CSF enhances the chemotactic and phagocytic activity of neutrophils and extends neutrophil survival⁵

Macrophage

macrophage

Macrophage: immune regulator

Macrophages are highly adaptable and dynamic phagocytes that orchestrate the body’s response to infection⁶
They prime and stimulate T cells, promote tissue repair and wound healing, mediate defense against fungal and bacterial pathogens, and produce anti- and pro-inflammatory cytokines⁶
GM-CSF augments the ability of macrophages to phagocytize and destroy bacteria and fungi^1,5

Dendritic Cell

dendritic cell

Dendritic cell: antigen presenter

Dendritic cells are responsible for antigen presentation and immune response regulation⁸
They initiate long-lasting and pathogen-specific immunity⁸
GM-CSF links innate and adaptive immunity by inducing the growth and maturation of antigen-presenting myeloid-derived dendritic cells^1,8

G-CSF=granulocyte-colony stimulating factor; GM-CSF=granulocyte-macrophage colony-stimulating factor.

Important Safety Information for LEUKINE^® (sargramostim)

Contraindications

Do not administer LEUKINE to patients with a history of serious allergic reaction, including anaphylaxis, to human granulocyte-macrophage colony-stimulating factor, sargramostim, yeast-derived products, or any other component of LEUKINE.

Warnings and Precautions

Serious hypersensitivity reactions, including anaphylactic reactions, have been reported with LEUKINE. If a serious allergic or anaphylactic reaction occurs, immediately discontinue LEUKINE therapy, and institute medical management. Discontinue LEUKINE permanently for patients with serious allergic reactions.
LEUKINE can cause infusion-related reactions that may be characterized by respiratory distress, hypoxia, flushing, hypotension, syncope, and/or tachycardia. Observe closely during infusion, particularly in patients with preexisting lung disease; dose adjustment or discontinuation may be needed.
LEUKINE should not be administered simultaneously with or within 24 hours preceding cytotoxic chemotherapy or radiotherapy or within 24 hours following chemotherapy.
Edema, capillary leak syndrome, and pleural or pericardial effusions have been reported in patients after LEUKINE administration. LEUKINE should be used with caution in patients with preexisting fluid retention, pulmonary infiltrates, or congestive heart failure. Such patients should be monitored.
Supraventricular arrhythmia has been reported in uncontrolled studies during LEUKINE administration, particularly in patients with a history of cardiac arrhythmia. Use LEUKINE with caution in patients with preexisting cardiac disease.
If absolute neutrophil count (ANC) > 20,000 cells/mm³ or if white blood cell (WBC) counts > 50,000/mm³, LEUKINE administration should be interrupted, or the dose reduced by half. Monitor complete blood counts (CBC) with differential twice per week.
Discontinue LEUKINE therapy if tumor progression, particularly in myeloid malignancies, is detected during LEUKINE treatment.
Treatment with LEUKINE may induce neutralizing anti-drug antibodies. Use LEUKINE for the shortest duration needed.
Avoid administration of solutions containing benzyl alcohol (including LEUKINE for injection reconstituted with Bacteriostatic Water for Injection, USP [0.9 % benzyl alcohol]) to neonates and low birth weight infants.

Drug Interactions

Avoid the concomitant use of LEUKINE and products that induce myeloproliferation. Monitor for clinical and laboratory signs of excess myeloproliferative effects.

Adverse Reactions

Adverse events occurring in >10% of patients receiving LEUKINE in controlled clinical trials and reported at a higher frequency than in placebo patients are:

In recipients of autologous bone marrow transplantation (BMT)–asthenia, malaise, diarrhea, rash, peripheral edema, urinary tract disorder
In recipients of allogeneic BMT–abdominal pain, chills, chest pain, diarrhea, nausea, vomiting, hematemesis, dysphagia, GI hemorrhage, pruritus, bone pain, arthralgia, eye hemorrhage, hypertension, tachycardia, bilirubinemia, hyperglycemia, increased creatinine, hypomagnesemia, edema, pharyngitis, epistaxis, dyspnea, insomnia, anxiety, high glucose, low albumin
In patients with AML–fever, weight loss, nausea, vomiting, anorexia, skin reactions, metabolic laboratory abnormalities, edema

Please see full Prescribing Information for LEUKINE at www.leukine.com.

Indications and Usage

LEUKINE (sargramostim) is a glycosylated recombinant human granulocyte-macrophage colony-stimulating factor (rhu GM-CSF) produced by recombinant DNA technology in yeast. LEUKINE is indicated:

To shorten time to neutrophil recovery and to reduce the incidence of severe and life-threatening infections and infections resulting in death following induction chemotherapy in adult patients 55 years and older with acute myeloid leukemia (AML).
For the mobilization of hematopoietic progenitor cells into peripheral blood for collection by leukapheresis and autologous transplantation in adult patients.
For the acceleration of myeloid reconstitution following autologous bone marrow or peripheral blood progenitor cell transplantation in adult and pediatric patients 2 years of age and older.
For the acceleration of myeloid reconstitution following allogeneic bone marrow transplantation in adult and pediatric patients 2 years of age and older.
For treatment of delayed neutrophil recovery or graft failure after autologous or allogeneic bone marrow transplantation in adult and pediatric patients 2 years of age and older.

Important Safety Information for LEUKINE^® (sargramostim)

Contraindications

Do not administer LEUKINE to patients with a history of serious allergic reaction, including anaphylaxis, to human granulocyte-macrophage colony-stimulating factor, sargramostim, yeast-derived products, or any other component of LEUKINE.

Warnings and Precautions

Serious hypersensitivity reactions, including anaphylactic reactions, have been reported with LEUKINE. If a serious allergic or anaphylactic reaction occurs, immediately discontinue LEUKINE therapy, and institute medical management. Discontinue LEUKINE permanently for patients with serious allergic reactions.
LEUKINE can cause infusion-related reactions that may be characterized by respiratory distress, hypoxia, flushing, hypotension, syncope, and/or tachycardia. Observe closely during infusion, particularly in patients with preexisting lung disease; dose adjustment or discontinuation may be needed.
LEUKINE should not be administered simultaneously with or within 24 hours preceding cytotoxic chemotherapy or radiotherapy or within 24 hours following chemotherapy.
Edema, capillary leak syndrome, and pleural or pericardial effusions have been reported in patients after LEUKINE administration. LEUKINE should be used with caution in patients with preexisting fluid retention, pulmonary infiltrates, or congestive heart failure. Such patients should be monitored.
Supraventricular arrhythmia has been reported in uncontrolled studies during LEUKINE administration, particularly in patients with a history of cardiac arrhythmia. Use LEUKINE with caution in patients with preexisting cardiac disease.
If absolute neutrophil count (ANC) > 20,000 cells/mm³ or if white blood cell (WBC) counts > 50,000/mm³, LEUKINE administration should be interrupted, or the dose reduced by half. Monitor complete blood counts (CBC) with differential twice per week.
Discontinue LEUKINE therapy if tumor progression, particularly in myeloid malignancies, is detected during LEUKINE treatment.
Treatment with LEUKINE may induce neutralizing anti-drug antibodies. Use LEUKINE for the shortest duration needed.
Avoid administration of solutions containing benzyl alcohol (including LEUKINE for injection reconstituted with Bacteriostatic Water for Injection, USP [0.9 % benzyl alcohol]) to neonates and low birth weight infants.

Drug Interactions

Avoid the concomitant use of LEUKINE and products that induce myeloproliferation. Monitor for clinical and laboratory signs of excess myeloproliferative effects.

Adverse Reactions

Adverse events occurring in >10% of patients receiving LEUKINE in controlled clinical trials and reported at a higher frequency than in placebo patients are:

In recipients of autologous bone marrow transplantation (BMT)–asthenia, malaise, diarrhea, rash, peripheral edema, urinary tract disorder
In recipients of allogeneic BMT–abdominal pain, chills, chest pain, diarrhea, nausea, vomiting, hematemesis, dysphagia, GI hemorrhage, pruritus, bone pain, arthralgia, eye hemorrhage, hypertension, tachycardia, bilirubinemia, hyperglycemia, increased creatinine, hypomagnesemia, edema, pharyngitis, epistaxis, dyspnea, insomnia, anxiety, high glucose, low albumin
In patients with AML–fever, weight loss, nausea, vomiting, anorexia, skin reactions, metabolic laboratory abnormalities, edema

Please see full Prescribing Information for LEUKINE at www.leukine.com.

Indications and Usage

LEUKINE (sargramostim) is a glycosylated recombinant human granulocyte-macrophage colony-stimulating factor (rhu GM-CSF) produced by recombinant DNA technology in yeast. LEUKINE is indicated:

To shorten time to neutrophil recovery and to reduce the incidence of severe and life-threatening infections and infections resulting in death following induction chemotherapy in adult patients 55 years and older with acute myeloid leukemia (AML).
For the mobilization of hematopoietic progenitor cells into peripheral blood for collection by leukapheresis and autologous transplantation in adult patients.
For the acceleration of myeloid reconstitution following autologous bone marrow or peripheral blood progenitor cell transplantation in adult and pediatric patients 2 years of age and older.
For the acceleration of myeloid reconstitution following allogeneic bone marrow transplantation in adult and pediatric patients 2 years of age and older.
For treatment of delayed neutrophil recovery or graft failure after autologous or allogeneic bone marrow transplantation in adult and pediatric patients 2 years of age and older.

References: 1. Leukine [package insert]. Boston, MA: Partner Therapeutics, Inc.; 2023. 2. Gunsilius E, Gastl G, Petzer AL. Biomed Pharmacother. 2001;55(4):186-194. 3. Kaushansky K. N Engl J Med. 2006;354(19):2034-2045. 4. Kaushansky K. In: Lichtman MA et al, eds. Williams Hematology. 7th ed. New York, NY: McGraw-Hill Companies, Inc.; 2006:chapt 15. 5. Armitage JO. Blood. 1998;92(12):4491-4508. 6. Shapouri-Moghaddam A, Mohammadian S, Vazini H, et al. J Cell Physiol. 2018;233(9):6425-6440. 7. Mayadas TN, Cullere X, Lowell CA. Annu Rev Pathol. 2014;9:181-218. 8. Mellman I. Cancer Immunol Res. 2013;1(3):145-149. 9. Huang F, et al. Am J Respir Crit Care Med. 2011;184:259–268. 10. Standiford LR, et al. Am J Physiol Lung Cell Mol Physiol. 2012;302:L447–L454. 11. Ballinger MN, et al. Am J Respir Cell Mol Biol. 2006;34:766–774.