Leukine Dosage

Leukine

Generic name: sargramostim
Drug class: Colony stimulating factors

Medically reviewed by  A Ras MD.

Recommended Adult Dosing

Dosage forms:  INJ

Neutropenia, post-AML induction chemo

[250 mcg/m^2/dose IV qd]

Start: on day 11 or 4 days after induction chemo if <5% blasts on day 10; Info: cont. tx until ANC >1500 x3 consecutive days or for up to 42 days; decr. dose 50% or interrupt tx if WBC >20,000; do not give w/in 24h before or after chemo or XRT

Peripheral blood progenitor cell mobilization

[250 mcg/m^2/dose SC qd]

Alt: 250 mcg/m^2/day IV continuous infusion qd; Info: cont. through PBPC collection period; decr. dose 50% if WBC >50,000

Neutropenia, post-peripheral blood progenitor cell transplant

[250 mcg/m^2/dose SC qd]

Start: immed. after PBPC infusion; Alt: 250 mcg/m^2/day IV continuous infusion qd; Info: cont. tx until ANC >1500 x3 consecutive days; do not give w/in 24h before or after chemo or XRT

Neutropenia, post-BMT

[250 mcg/m^2/dose IV qd]

Start: 2-4h after bone marrow infusion only if post-marrow infusion ANC <500; Info: cont. tx until ANC >1500 x3 consecutive days; do not give w/in 24h before or after chemo or XRT; decr. dose 50% or interrupt tx if WBC >50,000 or ANC >20,000 in allogeneic BMT pts

BMT failure/engraftment delay

[250 mcg/m^2/dose IV qd x14 days]

Info: may repeat course if no engraftment; if 3rd course needed may incr. to 500 mcg/m^2/dose IV qd x14 days; must wait 7 days between courses; decr. dose 50% or interrupt tx if WBC >50,000 or ANC >20,000

Hematopoietic syndrome of acute radiation syndrome

[7 mcg/kg/dose SC qd]

Start: ASAP after suspected or confirmed exposure to radiation doses >2 Gy; Info: cont. tx until ANC >1000 x3 consecutive CBCs or ANC >10,000 after radiation-induced nadir

High-risk neuroblastoma, relapsed or refractory

[naxitamab adjunct]

Dose: 250 mcg/m^2/dose SC qd on days -4, -3, -2, -1, 0, then 500 mcg/m^2/dose SC qd on days 1-5 of each naxitamab cycle; Start: 5 days before 1st naxitamab dose

Renal dosing

renal impairment: no adjustment

HD/PD: not defined

Hepatic dosing

[not defined]

Recommended Peds Dosing

Dosage forms:  INJ

Hematopoietic syndrome of acute radiation syndrome

[<15 kg]

Dose: 12 mcg/kg/dose SC qd; Start: ASAP after suspected or confirmed exposure to radiation doses >2 Gy; Info: cont. tx until ANC >1000 x3 consecutive CBCs or ANC >10,000 after radiation-induced nadir

[15-40 kg]

Dose: 10 mcg/kg/dose SC qd; Start: ASAP after suspected or confirmed exposure to radiation doses >2 Gy; Info: cont. tx until ANC >1000 x3 consecutive CBCs or ANC >10,000 after radiation-induced nadir

[>40 kg]

Dose: 7 mcg/kg/dose SC qd; Start: ASAP after suspected or confirmed exposure to radiation doses >2 Gy; Info: cont. tx until ANC >1000 x3 consecutive CBCs or ANC >10,000 after radiation-induced nadir

High-risk neuroblastoma, relapsed or refractory

[dinutuximab adjunct]

Dose: 250 mcg/m^2/dose SC/IV qd on days 1-14 of 24-day cycle; give only w/ cycles 1, 3, 5 of dinutuximab

[naxitamab adjunct, 1 yo and older]

Dose: 250 mcg/m^2/dose SC qd x5 days on days -4, -3, -2, -1, 0, then 500 mcg/m^2/dose SC qd x5 days on days 1-5 of each naxitamab cycle; Start: 5 days before 1st naxitamab dose

Renal dosing

[not defined]

renal impairment: consider adult renal dosing for guidance

HD/PD: not defined

Hepatic dosing

[not defined]

SRC: NLM .