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Sargramostim (Monograph)

Brand name: Leukine
Drug class: Hematopoietic Agents

Medically reviewed by Drugs.com on Nov 20, 2023. Written by ASHP.

Introduction

Biosynthetic hematopoietic agent that affects the proliferation and differentiation of a variety of hematopoietic progenitor cells; recombinant human granulocyte-macrophage colony-stimulating factor (GM-CSF).1 5 131 132

Uses for Sargramostim

Acute Myeloid Leukemia (AML) After Induction Chemotherapy

Used to accelerate neutrophil recovery and reduce the incidence of severe and life-threatening infections following induction chemotherapy in adults ≥55 years of age with AML.1 220

Autologous Peripheral Blood Progenitor Cell (PBPC) Mobilization and Collection

Used to mobilize hematopoietic progenitor cells into peripheral blood for collection by leukapheresis in adults with cancer undergoing autologous hematopoietic stem cell transplantation (HSCT).1

Autologous PBPC and Bone Marrow Transplantation (BMT)

Used to accelerate myeloid recovery following autologous PBPC or BMT in adults and pediatric patients ≥2 years of age with non-Hodgkin lymphoma (NHL), acute lymphoblastic leukemia (ALL), or Hodgkin lymphoma (HL).1 5 7 8 12 55 75 77 78 91 96 173 174 196

Allogeneic BMT

Used to accelerate myeloid recovery in adults and pediatric patients ≥2 years of age undergoing allogeneic BMT from human leukocyte antigen (HLA)-matched related donors.1 5 21 112 173

Allogeneic or Autologous BMT: Treatment of Delayed Neutrophil Recovery or Graft Failure

Used to increase survival in adults and pediatric patients ≥2 years of age who have undergone allogeneic or autologous BMT and in whom engraftment is delayed or has failed.1 18 19

Acute Exposure to Myelosuppressive Doses of Radiation

Used to improve survival in adults and pediatric patients from birth to 17 years of age acutely exposed to myelosuppressive doses of radiation.1

Sargramostim Dosage and Administration

General

Patient Monitoring

Administration

Administer by IV infusion or sub-Q injection; route of administration differs depending on indication for use.1

Should be administered under the guidance and supervision of a clinician, but may be self-administered outside of a hospital or medical office setting (e.g., at home) if the clinician determines that the patient and/or caregiver is competent to prepare and safely administer the drug.1

Do not administer concomitantly with or within 24 hours preceding cytotoxic chemotherapy or radiotherapy or within 24 hours following chemotherapy.1

IV Administration

Do not administer IV infusion through an in-line membrane filter.1 Do not add other medications to infusion solutions containing sargramostim.1

Generally infused IV over 2–4 hours.1 5 7 18 19 21 30 55 95 112 Also has been administered by IV infusion over 30–60 minutes,59 129 over 5–12 hours,44 129 or by continuous IV infusion over 24 hours.1 5 47 48 54 59 73 119 134

Reconstitution

Reconstitute prior to administration by adding 1 mL of sterile water for injection (without preservative) or bacteriostatic water for injection (with 0.9% benzyl alcohol) to provide a single-dose solution containing 250 mcg/mL.1 Do not mix the contents of vials reconstituted with different diluents together.1 Reconstitute only with sterile water for injection (without preservative) when administering to neonates or infants in order to avoid benzyl alcohol exposure.1

Dilution

Dilute the reconstituted solution in 0.9% sodium chloride injection.1 If the final concentration is <10 mcg/mL, add albumin (human) to a final concentration of 0.1% in order to prevent adsorption of sargramostim to the drug delivery system.1 Use immediately after dilution.1

Sub-Q Administration

Reconstitution

Reconstitute prior to administration by adding 1 mL of sterile water for injection (without preservative) or bacteriostatic water for injection (with 0.9% benzyl alcohol) to provide a single-dose solution containing 250 mcg/mL.1 Do not mix the contents of vials reconstituted with different diluents together.1 Reconstitute only with sterile water for injection (without preservative) when administering to neonates or infants in order to avoid benzyl alcohol exposure.1

Dilution

No further dilution of the reconstituted vial is required prior to sub-Q injection.1

Dosage

Pediatric Patients

Autologous Peripheral Blood Progenitor Cell (PBPC) Transplantation in Pediatric Patients ≥2 Years of Age with NHL, ALL, or HL
IV

250 mcg/m2/day IV over 24 hours.1

Initiate immediately after progenitor cell infusion and continue until ANC >1500 cells/mm3 for 3 consecutive days.1

Sub-Q

250 mcg/m2/day once daily.1

Initiate immediately after progenitor cell infusion and continue until ANC >1500 cells/mm3 for 3 consecutive days.1

Autologous Bone Marrow Transplantation (BMT) in Pediatric Patients ≥2 Years of Age with NHL, ALL, or HL
IV

250 mcg/m2/day IV over 2 hours beginning 2 to 4 hours after bone marrow infusion, and not <24 hours after the last dose of chemotherapy or radiotherapy.1

Do not administer until post marrow infusion ANC is <500 cells/mm3 and continue until ANC >1500 cells/mm3 for 3 consecutive days.1

Allogeneic BMT in Pediatric Patients ≥2 Years of Age
IV

250 mcg/m2/day IV over 2 hours beginning 2 to 4 hours after bone marrow infusion, and not <24 hours after the last dose of chemotherapy or radiotherapy.1

Do not administer until post marrow infusion ANC is <500 cells/mm3 and continue until ANC >1500 cells/mm3 for 3 consecutive days.1

Obtain a CBC with differential twice weekly during therapy.1 If disease progression or blast cell appearance occurs, discontinue immediately.1 If grade 3 or 4 adverse reactions occur, reduce the dose by 50% or interrupt therapy until the reaction resolves.1 If WBC >50,000 cells/mm3 or ANC >20,000 cells/mm3occurs, interrupt therapy or reduce dose by 50%.1

Allogeneic or Autologous BMT: Treatment of Delayed Neutrophil Recovery of Graft Failure in Pediatric Patients ≥2 years of age
IV

250 mcg/m2/day IV over 2 hours for 14 days.1

If neutrophil recovery does not occur after 7 days off therapy, repeat the dose.1 If recovery still does not occur after another 7 days off therapy, administer a third course of sargramostim 500 mcg/m2/day for 14 days.1 If there is still no improvement, further dose escalation is unlikely to be beneficial.1

Obtain a CBC with differential twice weekly during therapy.1 If disease progression or blast cell appearance occurs, discontinue immediately.1 If grade 3 or 4 adverse reactions occur, reduce dose by 50% or interrupt therapy until the reaction resolves.1 If WBC >50,000 cells/mm3 or ANC >20,000 cells/mm3 occurs, interrupt therapy or reduce dose by 50%.1

Acute Exposure to Myelosuppressive Doses of Radiation in Pediatric Patients (Birth to 17 Years of Age)
Sub-Q

Weight-based dosing as follows:1

For patients >40 kg: 7 mcg/kg once daily.1

For patients 15 to 40 kg: 10 mcg/kg once daily.1

For patients <15 kg: 12 mcg/kg once daily.1

Initiate therapy as soon as possible after suspected or confirmed exposure to radiation doses >2 Gray.1

Obtain a baseline CBC with differential and then serial CBCs approximately every third day.1 Continue therapy until ANC >1000 cells/mm3 for 3 consecutive CBCs or exceeds 10,000 cells/mm3 after a radiation-induced nadir.1 Do not delay therapy if a CBC is not readily available.1

Estimate the level of radiation exposure via clinical findings, biodosimetry (if available), and information from public health authorities.1

Adults

AML Following Induction Chemotherapy in Adults ≥55 Years of Age
IV

250 mcg/m2/day IV over 4 hours starting approximately on day 11 or four days following the completion of induction chemotherapy, if the day 10 bone marrow is hypoplastic with <5% blasts.1 If a second induction chemotherapy cycle is required, administer approximately 4 days after completion of chemotherapy if bone marrow is hypoplastic with <5% blasts.1 Continue therapy until ANC >1500 cells/mm3 for 3 consecutive days or a maximum of 42 days.1

Obtain a CBC with differential twice weekly during therapy.1 If leukemic regrowth occurs, discontinue immediately.1 If grade 3 or 4 adverse reactions occur, reduce dose by 50% or interrupt therapy until the reaction resolves.1 If an ANC >20,000 cells/mm3 occurs, interrupt therapy or reduce the dose by 50%.1

Autologous PBPC Mobilization and Collection
IV

250 mcg/m2/day IV over 24 hours.1

Continue at the same dose throughout the PBPC collection period.1 Reduce dose by 50% if WBC >50,000 cells/mm3.1 If adequate PBPC collection is not achieved, consider other mobilization therapy.1

Sub-Q

250 mcg/m2/day once daily.1

Continue at the same dose throughout the PBPC collection period.1 Reduce dose by 50% if WBC >50,000 cells/mm3.1 If adequate PBPC collection is not achieved, consider other mobilization therapy.1

Autologous PBPC Transplantation in Adults with NHL, ALL, or HL
IV

250 mcg/m2/day IV over 24 hours.1

Initiate immediately after progenitor cell infusion and continue until ANC >1500 cells/mm3 for 3 consecutive days.1

Sub-Q

250 mcg/m2/day once daily.1

Initiate immediately after progenitor cell infusion and continue until ANC >1500 cells/mm3 for 3 consecutive days.1

Autologous BMT in Adults with NHL, ALL or HL
IV

250 mcg/m2/day IV over 2 hours beginning 2 to 4 hours after bone marrow infusion, and not <24 hours after the last dose of chemotherapy or radiotherapy.1

Do not administer until post marrow infusion ANC <500 cells/mm3 and continue until ANC >1500 cells/mm3 for 3 consecutive days.1

Allogeneic BMT
IV

250 mcg/m2/day IV over 2 hours beginning 2 to 4 hours after bone marrow infusion, and not <24 hours after the last dose of chemotherapy or radiotherapy.1 Do not administer until post marrow infusion ANC <500 cells/mm3 and continue until ANC >1500 cells/mm3 for 3 consecutive days.1

Obtain a CBC with differential twice weekly during therapy.1 If disease progression or blast cell appearance occurs, discontinue immediately.1 If grade 3 or 4 adverse reactions occur, reduce dose by 50% or interrupt therapy until the reaction resolves.1 If WBC >50,000 cells/mm3 or ANC >20,000 cells/mm3 occurs, interrupt therapy or reduce dose by 50%.1

Allogeneic or Autologous BMT: Treatment of Delayed Neutrophil Recovery of Graft Failure
IV

250 mcg/m2/day IV over 2 hours for 14 days.1 If neutrophil recovery does not occur after 7 days off therapy, repeat the dose.1 If recovery still does not occur after another 7 days off therapy, administer a third course of sargramostim 500 mcg/m2/day for 14 days.1 If there is still no improvement, further dose escalation is unlikely to be beneficial.1

Obtain a CBC with differential twice weekly during therapy.1 If disease progression or blast cell appearance occurs, discontinue immediately.1 If grade 3 or 4 adverse reactions occur, reduce dose by 50% or interrupt therapy until the reaction resolves.1 If WBC >50,000 cells/mm3 or ANC >20,000 cells/mm3 occurs, interrupt therapy or reduce the dose by 50%.1

Acute Exposure to Myelosuppressive Doses of Radiation
Sub-Q

7 mcg/kg once daily.1 Initiate therapy as soon as possible after suspected or confirmed exposure to radiation doses >2 Gray.1

Obtain a baseline CBC with differential and then serial CBCs approximately every third day.1 Continue therapy until ANC >1000 cells/mm3 for 3 consecutive CBCs or exceeds 10,000 cells/mm3 after a radiation-induced nadir.1 Do not delay therapy if a CBC is not readily available.1

Estimate the level of radiation exposure via clinical findings, biodosimetry (if available), and information from public health authorities.1

Special Populations

Hepatic Impairment

No specific dosage recommendations.1

Renal Impairment

No specific dosage recommendations.1

Geriatric Use

No specific dosage recommendations.1

Detailed Sargramostim dosage information

Cautions for Sargramostim

Contraindications

Warnings/Precautions

Hypersensitivity Reactions

Serious hypersensitivity reactions, including anaphylaxis, reported.1 Employ appropriate precautions in case a reaction occurs.1 Discontinue therapy if a serious allergic or anaphylactic reaction occurs and initiate medical management.1 Permanently discontinue therapy in patients who experience serious allergic reactions.1

Infusion-related Reactions

Infusion-related reactions may occur following initial administration in a particular cycle.1 Observe patients closely for signs and symptoms of infusion-related reactions, especially those with pre-existing pulmonary disease.1 Reduce the rate of the sargramostim infusion by 50% if acute symptoms develop.1 Discontinue the infusion if symptoms persist or worsen despite dosage reduction.1 Administer subsequent IV infusions following the standard dose schedule with careful monitoring in those who experience infusion-related reactions.1

Risk of Severe Myelosuppression

Do not administer sargramostim with or within 24 hours prior to cytotoxic chemotherapy or radiotherapy or within 24 hours following chemotherapy due to an increased risk of severe myelosuppression.1

Effusions and Capillary Leak Syndrome

Edema, capillary leak syndrome, and pleural and/or pericardial effusion reported.1 Administration of sargramostim may aggravate preexisting fluid retention.1 Dose reduction or interruption of sargramostin, with or without diuretic therapy, may reverse therapy-related fluid retention.1 Use sargramostim with caution in patients with preexisting fluid retention, pulmonary infiltrates, or heart failure.1 Monitor body weight and hydration status during sargramostim administration.1

Supraventricular Arrhythmias

Supraventricular arrhythmias reported, particularly in patients with a history of cardiac arrhythmia.1 Discontinuation of sargramostim may reverse arrhythmic effects.1 Use sargramostim with caution in patients with preexisting cardiac disease.1

Leukocytosis

Leukocytosis (WBC ≥50,000 cells/mm3) reported.1 Monitor CBC with differential twice weekly and consider whether to reduce the dose of sargramostim, or interrupt treatment, based on the clinical condition of the patient.1 Following discontinuation, a return to normal or baseline blood count levels generally occurs within 3 to 7 days.1

Potential Effect on Malignant Cells

May potentially act as a growth factor for any tumor type, especially myeloid malignancies.1 Exercise caution when administering sargramostim to patients with a malignancy with myeloid characteristics.1 Discontinue treatment if progression occurs during therapy.1

Immunogenicity

Anti-drug neutralizing antibodies were reported in 82.9% of patients receiving sargramostim for up to 12 months in a clinical study for an unapproved use.1 Administer sargramostim for the shortest necessary duration.1

Risk of Serious Reactions in Infants Due to Benzyl Alcohol

Administration of solutions containing benzyl alcohol to neonates and low birth weight infants may result in serious and fatal adverse reactions including “gasping syndrome”.1 Avoid administration of sargramostim for injection reconstituted with Bacteriostatic Water for Injection (0.9% benzyl alcohol) in these patients.1 Administer these patients lyophilized sargramostim reconstituted with Sterile Water for Injection instead.1 Consider the combined daily metabolic load of benzyl alcohol from all sources if benzyl alcohol-reconstituted sargramostim must be used in neonates and low birth weight infants.1

Specific Populations

Pregnancy

Limited data on use in pregnant women; may cause embryofetal harm based on animal findings.1 Advise women of childbearing potential of potential fetal risks.1

Benzyl alcohol, a preservative present in Bacteriostatic Water for Injection, has been associated with gasping syndrome in neonates and low birth weight infants.1 If sargramostim is necessary during pregnancy, reconstitute the drug only with Sterile Water for Injection without preservatives.1

Lactation

It is not known whether sargramostim is distributed into milk, affects milk production, or affects the breast-fed infant.1 Advise lactating women not to breast-feed during treatment and for at least 2 weeks after the last dose of sargramostim.1

Pediatric Use

The efficacy and safety of sargramostim have been established in pediatric patients ≥2 years of age for autologous peripheral blood progenitor cells and BMT, allogeneic BMT, and treatment of delayed neutrophil recovery or graft failure based on studies performed in adults and a limited number of pediatric patients.1 The efficacy and safety of sargramostim have also been established in the setting of acute exposure to myelosuppressive doses of radiation among pediatric patients from birth to 17 years of age.1

In neonates and low birth weight infants, avoid the use of sargramostim solutions reconstituted with Bacteriostatic Water for Injection due to the presence of the preservative, benzyl alcohol.1

Geriatric Use

Experience in patients ≥65 years of age is insufficient to determine whether they respond differently to sargramostim than younger patients.1

Common Adverse Effects

Most common (>30%) adverse reactions in recipients of autologous BMT include: fever, nausea, diarrhea, vomiting, mucus membrane disorder, alopecia, asthenia, malaise, anorexia, rash, GI disorder, edema.1

Most common (>30%) adverse reactions in recipients of allogeneic BMT include: diarrhea, fever, nausea, rash, vomiting, stomatitis, anorexia, increased glucose, alopecia, abdominal pain, low albumin, headache, hypertension.1

Most common (>30%) adverse reactions in patients with AML include: fever, liver toxicity, skin reactions, infections, metabolic laboratory abnormalities, nausea, diarrhea, genitourinary abnormalities, pulmonary toxicity, vomiting, neurotoxicity, stomatitis, alopecia, weight loss.1

Drug Interactions

Drugs with Myeloproliferative Effects

Avoid drugs that could potentiate the myeloproliferative effects of sargramostim (e.g., lithium, corticosteroids).1 If concomitant use is unavoidable, monitor patients frequently for clinical and laboratory signs of increased myeloproliferative effects.1

Sargramostim drug interactions (more detail)

Sargramostim Pharmacokinetics

Absorption

Bioavailability

Peak serum concentrations are attained during or immediately after completion of an IV infusion.1

Sargramostim was detected within 15 minutes and reached peak serum concentrations between 2.5 and 4 hours after sub-Q administration.1

When compared to the IV route, the absolute bioavailability with the sub-Q route was 75%.1

Elimination

Metabolism

Not known whether sargramostim is metabolized or how it is eliminated from the body.1

Since sargramostim is a protein, expected to degrade to small peptides and individual amino acids.1

Half-life

1.4 hours following sub-Q administration.1

Stability

Storage

Parenteral

Store single-dose vials under refrigeration (2-8°C) in their original carton; do not freeze or shake and protect from light.1

Store reconstituted solution under refrigeration (2-8°C); do not freeze.1

Actions

Advice to Patients

Additional Information

The American Society of Health-System Pharmacists, Inc. represents that the information provided in the accompanying monograph was formulated with a reasonable standard of care, and in conformity with professional standards in the field. Readers are advised that decisions regarding use of drugs are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and that the information contained in the monograph is provided for informational purposes only. The manufacturer’s labeling should be consulted for more detailed information. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information contained in the monograph is not a substitute for medical care.

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.

Sargramostim (Recombinant DNA Origin)

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Parenteral

For injection, for subcutaneous or IV use

250 mcg

Leukine

Partner Therapeutics

AHFS DI Essentials™. © Copyright 2024, Selected Revisions November 20, 2023. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.

References

1. Partner Therapeutics, Inc. Leukine (sargramostim) prescribing information. Lexington, MA; 2022 May.

3. Rose RM. The role of colony-stimulating factors in infectious disease: current status, future challenges. Semin Oncol. 1992; 19:415-21. http://www.ncbi.nlm.nih.gov/pubmed/1380731?dopt=AbstractPlus

4. Crosier PS, Clark SC. Basic biology of the hematopoietic growth factors. Semin Oncol. 1992; 19:349-61. http://www.ncbi.nlm.nih.gov/pubmed/1380728?dopt=AbstractPlus

5. Grant SM, Heel RC. Recombinant granulocyte-macrophage colony-stimulating factor (rGM-CSF): a review of its pharmacological properties and prospective role in the management of myelosuppression. Drugs. 1992; 43:516-60.

7. Nemunaitis J, Singer JW, Buckner CD et al. Use of recombinant human granulocyte-macrophage colony-stimulating factor in autologous marrow transplantation for lymphoid malignancies. Blood. 1988; 72:834-6. http://www.ncbi.nlm.nih.gov/pubmed/3042050?dopt=AbstractPlus

8. Nemunaitis J, Rabinowe SN, Singer JW et al. Recombinant granulocyte-macrophage colony-stimulating factor after autologous bone marrow transplantation for lymphoid cancer. N Engl J Med. 1991; 324:1773-8. http://www.ncbi.nlm.nih.gov/pubmed/1903847?dopt=AbstractPlus

11. Goldstone AH, Khwaja A. The role of haemopoietic growth factors in bone marrow transplantation. Leukemia Research. 1990; 14:721-9. http://www.ncbi.nlm.nih.gov/pubmed/1697007?dopt=AbstractPlus

12. Devereaux S, Linch DC, Gribben JG et al. GM-CSF accelerates neutrophil recovery after autologous bone marrow transplantation for Hodgkin’s disease. Bone Marrow Transplant. 1989; 4:49-54. http://www.ncbi.nlm.nih.gov/pubmed/2647187?dopt=AbstractPlus

18. Nemunaitis J, Singer JW, Buckner CD et al. Use of recombinant human granulocyte-macrophage colony-stimulating factor in graft failure after bone marrow transplantation. Blood. 1990; 76:245-53. http://www.ncbi.nlm.nih.gov/pubmed/2194592?dopt=AbstractPlus

19. Vose JM, Bierman PJ, Kessinger A et al. The use of recombinant human granulocyte-macrophage colony-stimulating factor for the treatment of delayed engraftment following high dose therapy and autologous hematopoietic stem cell transplantation for lymphoid malignancies. Bone Marrow Transplant. 1991; 7:139-43. http://www.ncbi.nlm.nih.gov/pubmed/1675592?dopt=AbstractPlus

21. Nemunaitis J, Anasetti C, Storb R et al. Phase II trial of recombinant human granulocyte-macrophage colony-stimulating factor in patients undergoing allogeneic bone marrow transplantation from unrelated donors. Blood. 1992; 79:2572-7. http://www.ncbi.nlm.nih.gov/pubmed/1586709?dopt=AbstractPlus

23. Logothetis CJ, Dexeus FH, Sella A et al. Escalated therapy for refractory urothelial tumors: methotrexate-vinblastine-doxorubicin-cisplatin plus unglycosylated recombinant human granulocyte-macrophage colony-stimulating factor. J Natl Cancer Inst. 1990; 82:667-72. http://www.ncbi.nlm.nih.gov/pubmed/2181151?dopt=AbstractPlus

26. Herrmann F, Schulz G, Wieser M et al. Effect of granulocyte-macrophage colony-stimulating factor on neutropenia and related morbidity induced by myelotoxic chemotherapy. Am J Med. 1990; 88:619-24. http://www.ncbi.nlm.nih.gov/pubmed/2189305?dopt=AbstractPlus

27. Gutterman J, Vadhan-Raj S, Logothetis C et al. Effects of granulocyte-macrophage colony-stimulating factor in iatrogenic myelosuppresion, bone marrow failure, and regulation of host defense. Semin Hematol. 1990; 27(Suppl 3):15-24. http://www.ncbi.nlm.nih.gov/pubmed/2198660?dopt=AbstractPlus

28. Gulati SC, Bennett CL. Granulocyte-macrophage colony-stimulating factor (GM-CSF) as adjunct therapy in relapsed Hodgkin disease. Ann Intern Med. 1992; 116:177-82. http://www.ncbi.nlm.nih.gov/pubmed/1728202?dopt=AbstractPlus

29. Gianni AM, Bregni M, Siena S et al. Recombinant human granulocyte-macrophage colony-stimulating factor reduces hematologic toxicity and widens clinical applicability of high-dose cyclophosphamide treatment in breast cancer and non-Hodgkin’s lymphoma. J Clin Oncol. 1990; 8:768-78. http://www.ncbi.nlm.nih.gov/pubmed/2185337?dopt=AbstractPlus

30. Furman WL, Fairclough DL, Huhn RD et al. Therapeutic effects and pharmacokinetics of recombinant human granulocyte-macrophage colony-stimulating factor in childhood cancer patients receiving myelosuppressive chemotherapy. J Clin Oncol. 1991; 9:1022-8. http://www.ncbi.nlm.nih.gov/pubmed/2033415?dopt=AbstractPlus

31. deVries EG, Biesma B, Willemse PH et al. A double-blind placebo-controlled study with granulocyte-macrophage colony-stimulating factor during chemotherapy for ovarian carcinoma. Cancer Res. 1991; 51:116-22. http://www.ncbi.nlm.nih.gov/pubmed/1988077?dopt=AbstractPlus

33. Antmann KS, Griffin JD, Elias A et al. Effect of recombinant human granulocyte-macrophage colony-stimulating factor on chemotherapy-induced myelosuppression. N Engl J Med. 1988; 319:593-8. http://www.ncbi.nlm.nih.gov/pubmed/3045544?dopt=AbstractPlus

34. Scadden DT, Bering HA, Levine JD et al. Granulocyte-macrophage colony-stimulating factor mitigates the neutropenia of combined interferon alfa and zidovudine treatment of acquired immune deficiency syndrome-associated Kaposi’s sarcoma. J Clin Oncol. 1991; 9:802-8. http://www.ncbi.nlm.nih.gov/pubmed/2016623?dopt=AbstractPlus

35. Mitsuyasu RT. Use of recombinant interferons and hematopoietic growth factors in patients infected with human immunodeficiency virus. Rev Infect Dis. 1991; 13:979-84. http://www.ncbi.nlm.nih.gov/pubmed/1720567?dopt=AbstractPlus

36. Levine JD, Allan JD, Tessitore JH et al. Recombinant human granulocyte-macrophage colony-stimulating factor ameliorates zidovudine-induced neutropenia in patients with acquired immunodeficiency syndrome (AIDS)/AIDS-related complex. Blood. 1991; 78:3148-54. http://www.ncbi.nlm.nih.gov/pubmed/1742482?dopt=AbstractPlus

37. Israel DS, Plaisance KI. Neutropenia in patients infected with human immunodeficiency virus. Clin Pharm. 1991; 10:268-79. http://www.ncbi.nlm.nih.gov/pubmed/2032444?dopt=AbstractPlus

38. Groopman JE. Status of colony-stimulating factors in cancer and AIDS. Semin Oncol. 1990; 17(Suppl 1):31-7. http://www.ncbi.nlm.nih.gov/pubmed/2405493?dopt=AbstractPlus

39. Groopman JE. Antiretroviral therapy and immunomodulators in patients with AIDS. Am J Med. 1991; 90(Suppl 4A):18-21S.

43. Cheson BD. The myelodysplastic syndromes: current approaches to therapy. Ann Intern Med. 1990; 112:932-41. http://www.ncbi.nlm.nih.gov/pubmed/2187393?dopt=AbstractPlus

44. Ganser A, Volkers B, Greher J et al. Recombinant human granulocyte-macrophage colony-stimulating factor in patients with myelodysplastic syndromes—a phase I/II trial. Blood. 1989; 73:31-7. http://www.ncbi.nlm.nih.gov/pubmed/2642714?dopt=AbstractPlus

45. Herrmann F, Lindemann A, Klein H et al. Effect of recombinant human granulocyte-macrophage colony-stimulating factor in patients with myelodysplastic syndrome with excess blasts. Leukemia. 1989; 3:335-8. http://www.ncbi.nlm.nih.gov/pubmed/2654495?dopt=AbstractPlus

46. Thompson JA, Lee DJ, Kidd P et al. Subcutaneous granulocyte-macrophage colony-stimulating factor in patients with myelodysplastic syndrome: toxicity, pharmacokinetics, and hematological effects. J Clin Oncol. 1989; 7:629-37. http://www.ncbi.nlm.nih.gov/pubmed/2651578?dopt=AbstractPlus

47. Vadhan-Raj S, Keating M, Le Maistre A et al. Effects of recombinant human granulocyte-macrophage colony-stimulating factor in patients with myelodysplastic syndromes. N Engl J Med. 1987; 317:1545-52. http://www.ncbi.nlm.nih.gov/pubmed/3500414?dopt=AbstractPlus

48. Vadhan-Raj S, Broxmeyer HE, Spitzer G et al. Stimulation of nonclonal hematopoiesis and suppression of the neoplastic clone after treatment with recombinant human granulocyte-macrophage colony-stimulating factor in a patient with therapy-related myelodysplastic syndrome. Blood. 1989; 74:1491-8. http://www.ncbi.nlm.nih.gov/pubmed/2676013?dopt=AbstractPlus

50. Sallerfors S, Olofsson T. Granulocyte-macrophage colony-stimulating factor (GM-CSF) and granulocyte colony-stimulating factor (G-CSF) in serum during induction treatment of acute leukemia. Br J Haematol. 1991; 78:343-51. http://www.ncbi.nlm.nih.gov/pubmed/1714757?dopt=AbstractPlus

54. Buchner T, Hiddemann W, Koenigsmann M et al. Recombinant human granulocyte-macrophage colony-stimulating factor after chemotherapy in patients with acute myeloid leukemia at higher age or after relapse. Blood. 1991; 78:1190-7. http://www.ncbi.nlm.nih.gov/pubmed/1878586?dopt=AbstractPlus

55. Blazar BR, Kersey JH, McGlave PB et al. In vivo administration of recombinant human granulocyte/macrophage colony-stimulating factor in acute lymphoblastic leukemia patients receiving purged autografts. Blood. 1989; 73:849-57. http://www.ncbi.nlm.nih.gov/pubmed/2644992?dopt=AbstractPlus

56. Guinan EC, Sieff CA, Oette DH et al. A phase I/II trial of recombinant granulocyte-macrophage colony-stimulating factor for children with aplastic anemia. Blood. 1990; 76:1077-82. http://www.ncbi.nlm.nih.gov/pubmed/2205306?dopt=AbstractPlus

57. Champlin RE, Nimer SD, Ireland P et al. Treatment of refractory aplastic anemia with recombinant human granulocyte-macrophage-colony-stimulating factor. Blood. 1989; 73:694-9. http://www.ncbi.nlm.nih.gov/pubmed/2644986?dopt=AbstractPlus

58. Wodzinski MA, Hampton KK, Reilly JT. Differential effect of G-CSF and GM-CSF in acquired chronic neutropenia. Br J Haematol. 1991; 77:249. http://www.ncbi.nlm.nih.gov/pubmed/1706198?dopt=AbstractPlus

59. Welte K, Zeidler C, Reiter A et al. Differential effects of granulocyte-macrophage colony-stimulating factor and granulocyte colony-stimulating factor in children with severe congenital neutropenia. Blood. 1990; 75:1056-63. http://www.ncbi.nlm.nih.gov/pubmed/1689595?dopt=AbstractPlus

60. Schroten H, Roesler J, Breidenbach T et al. Granulocyte and granulocyte-macrophage colony-stimulating factors for treatment of neutropenia in glycogen storage disease type Ib. J Pediatr. 1991; 119:748-54. http://www.ncbi.nlm.nih.gov/pubmed/1719175?dopt=AbstractPlus

61. Russo CL, Glader BE, Israel RJ et al. Treatment of neutropenia associated with dyskeratosis congenita with granulocyte-macrophage colony-stimulating factor. Lancet. 1990; 336:751-2. http://www.ncbi.nlm.nih.gov/pubmed/1975922?dopt=AbstractPlus

62. Kurzrock R, Talpaz M, Gutterman JU. Treatment of cyclic neutropenia with very low doses of GM-CSF. Am J Med. 1991; 91:317-8. http://www.ncbi.nlm.nih.gov/pubmed/1892155?dopt=AbstractPlus

63. Ganser A, Ottmann OG, Erdmann H et al. The effect of recombinant human granulocyte-macrophage colony-stimulating factor on neutropenia and related morbidity in chronic severe neutropenia. Ann Intern Med. 1989; 111:887-92. http://www.ncbi.nlm.nih.gov/pubmed/2683920?dopt=AbstractPlus

73. Vadhan-Raj S, Buescher S, LeMaistre A et al. Stimulation of hematopoiesis in patients with bone marrow failure and in patients with malignancy by recombinant human granulocyte-macrophage colony-stimulating factor. Blood. 1988; 72:134-41. http://www.ncbi.nlm.nih.gov/pubmed/3291976?dopt=AbstractPlus

75. Vose JM, Bierman PJ, Armitage JO. Granulocyte-macrophage colony-stimulating factor (GM-CSF): answers or more questions? Ann Intern Med. 1992; 116:261-2. Editorial.

76. Shank WA, Balducci L. Recombinant hemopoietic growth factors: comparative hemopoietic response in younger and older subjects. J Am Geriatr Soc. 1992; 40:151-4. http://www.ncbi.nlm.nih.gov/pubmed/1371297?dopt=AbstractPlus

77. Sakamoto KM, Golde DW, Gasson JC. The biology and clinical applications of granulocyte-macrophage colony-stimulating factor. J Pediatr. 1991; 118:S17-20. http://www.ncbi.nlm.nih.gov/pubmed/1999769?dopt=AbstractPlus

78. Ruef C, Coleman DL. Granulocyte-macrophage colony-stimulating factor: pleiotropic cytokine with potential clinical usefulness. Clin Infect Dis. 1990; 12:41-62.

79. Reed SG, Nathan CF, Pihl DL et al. Recombinant granulocyte/macrophage colony-stimulating factor activates macrophages to inhibit Trypanosoma cruzi and release hydrogen peroxide. J Exp Med. 1987; 166:1734-46. http://www.ncbi.nlm.nih.gov/pubmed/3119762?dopt=AbstractPlus

81. Khwaja A, Goldstone AH. Haemopoietic growth factors: stimulation of white cells and platelets may transform cancer chemotherapy. BMJ. 1991; 302:1164-5. http://www.ncbi.nlm.nih.gov/pubmed/2043807?dopt=AbstractPlus

82. Furman WL, Crist WM. Potential uses of recombinant human granulocyte-macrophage colony-stimulating factor in children. Am J Pediatr Hematol/Oncol. 1991; 13:388-99.

83. Weisbart RH, Golde DW. Physiology of granulocyte and macrophage colony-stimulating factors in host defense. Hematol/Oncol Clin N Am. 1989; 3:401-9.

84. Weisbart RH, Gasson JC, Golde DW. Colony-stimulating factors and host defense. Ann Intern Med. 1989; 110:297-303. http://www.ncbi.nlm.nih.gov/pubmed/2536530?dopt=AbstractPlus

85. Morstyn G, Burgess AW. Hemopoietic growth factors: a review. Cancer Res. 1988; 48:5624-37. http://www.ncbi.nlm.nih.gov/pubmed/2458827?dopt=AbstractPlus

86. Mitsuyasu RT, Golde DW. Clinical role of granulocyte-macrophage colony-stimulating factor. Hematol/Oncol Clin N Am. 1989; 3:411-25.

88. Metcalf D. The colony stimulating factors: discovery, development, and clinical applications. Cancer. 1990; 65:2185-95. http://www.ncbi.nlm.nih.gov/pubmed/2189549?dopt=AbstractPlus

90. Metcalf D. The molecular biology and functions of the granulocyte-macrophage colony-stimulating factors. Blood. 1986; 6:257-67.

91. Groopman JE, Molina JM, Scadden DT. Hematopoietic growth factors: biology and clinical applications. N Engl J Med. 1989; 321:1449-59. http://www.ncbi.nlm.nih.gov/pubmed/2682244?dopt=AbstractPlus

92. Grabstein KH, Urdal DL, Tushinski RJ. Induction of macrophage tumoricidal activity by granulocyte-macrophage colony-stimulating factor. Science. 1986; 232:506-8. http://www.ncbi.nlm.nih.gov/pubmed/3083507?dopt=AbstractPlus

94. Aglietta M, Piacibello W, Sanavio F et al. Kinetics of human hemopoietic cells after in vivo administration of granulocyte-macrophage colony-stimulating factor. J Clin Invest. 1989; 83:551-7. http://www.ncbi.nlm.nih.gov/pubmed/2643633?dopt=AbstractPlus

95. Lieschke GJ, Burgess AW. Granulocyte colony-stimulating factor and granulocyte-macrophage colony-stimulating factor. (First of two parts.) N Engl J Med. 1992; 327:28-35.

96. Lieschke GJ, Burgess AW. Granulocyte colony-stimulating factor and granulocyte-macrophage colony-stimulating factor. (Second of two parts.) N Engl J Med. 1992; 327:99-106.

97. Roe TF, Coates TD, Thomas DW et al. Brief report: treatment of chronic inflammatory bowel disease in glycogen storage disease type Ib with colony-stimulating factors. N Engl J Med. 1992; 326:1666-9. http://www.ncbi.nlm.nih.gov/pubmed/1375344?dopt=AbstractPlus

99. Sulecki M, Rosenfeld GS, Przepiorka D et al. Treatment of ganciclovir-induced neutropenia with recombinant human GM-CSF. Am J Med. 1991; 90:401-2. http://www.ncbi.nlm.nih.gov/pubmed/1848397?dopt=AbstractPlus

100. Gribben JG, Devereux S, Thomas NS et al. Development of antibodies to unprotected glycosylation sites on recombinant human GM-CSF. Lancet. 1990; 335:434-7. http://www.ncbi.nlm.nih.gov/pubmed/1968169?dopt=AbstractPlus

101. Freund MR, Luft S, Schober C et al. Differential effect of GM-CSF and G-CSF in cyclic neutropenia. Lancet. 1990; 336:313. http://www.ncbi.nlm.nih.gov/pubmed/1695985?dopt=AbstractPlus

102. Cebon JS, Bury RW, Lieschke GJ et al. The effects of dose and route of administration on the pharmacokinetics of granulocyte-macrophage colony-stimulating factor. Eur J Can. 1990; 26:1064-9.

105. Metcalf D. The granulocyte-macrophage colony-stimulating factors. Science. 1985; 229:16-22. http://www.ncbi.nlm.nih.gov/pubmed/2990035?dopt=AbstractPlus

109. De Vries EG, Biesma B, Willemse PH et al. A double-blind placebo-controlled study with granulocyte-macrophage colony-stimulating factor during chemotherapy for ovarian carcinoma. Cancer Res. 1991; 51:116-22. http://www.ncbi.nlm.nih.gov/pubmed/1988077?dopt=AbstractPlus

110. Barlogie B, Jagannath S, Dixon DO et al. High-dose melphalan and granulocyte-macrophage colony-stimulating factor for refractory multiple myeloma. Blood. 1990; 76:677-80. http://www.ncbi.nlm.nih.gov/pubmed/2200536?dopt=AbstractPlus

111. Davey RT, Davey VJ, Metcalf JA et al. A phase I/II trial of zidovudine, interferon-α, and granulocyte-macrophage colony-stimulating factor in the treatment of human immunodeficiency virus type 1 infection. J Infect Dis. 1991; 164:43-52. http://www.ncbi.nlm.nih.gov/pubmed/1676045?dopt=AbstractPlus

112. Nemunaitis J, Buckner CD, Appelbaum FR et al. Phase I/II trial of recombinant human granulocyte-macrophage colony-stimulating factor following allogeneic bone marrow transplantation. Blood. 1991; 77:2065-71. http://www.ncbi.nlm.nih.gov/pubmed/1902125?dopt=AbstractPlus

114. Ho AD, Del Valle F, Engelhard M et al. Mitoxantrone/high-dose Ara-C and recombinant human GM-CSF in the treatment of refractory non-Hodgkin’s lymphoma. Cancer. 1990; 66:423-30. http://www.ncbi.nlm.nih.gov/pubmed/2194641?dopt=AbstractPlus

115. Steward WP, Scarffe JH, Dirix LY et al. Granulocyte-macrophage colony-stimulating factor (GM-CSF) after high-dose melphalan in patients with advanced colon cancer. Br J Cancer. 1990; 61:749-54. http://www.ncbi.nlm.nih.gov/pubmed/1692472?dopt=AbstractPlus

119. Wing EJ, Magee M, Whiteside TL et al. Recombinant human granulocyte/macrophage colony-stimulating factor enhances monocyte cytotoxicity and secretion of tumor necrosis factor and interferon in cancer patients. Blood. 1989; 643-6.

120. Ho AD, Del Valle F, Haas R et al. Sequential studies on the role of mitoxantrone, high-dose cytarabine, and recombinant human granulocyte-macrophage colony-stimulating factor in the treatment of refractory non-Hodgkin’s lymphoma. Semin Oncol. 1990; 17(Suppl 10):14-9. http://www.ncbi.nlm.nih.gov/pubmed/2259918?dopt=AbstractPlus

121. Socinski MA, Cannistra SA, Elias A et al. Granulocyte-macrophage colony-stimulating factor expands the circulating haemopoietic progenitor cell compartment in man. Lancet. 1988; 1:1194-8. http://www.ncbi.nlm.nih.gov/pubmed/2897009?dopt=AbstractPlus

122. Lieschke GJ, Maher D, Cebon J et al. Effects of bacterially synthesized recombinant human granulocyte-macrophage colony-stimulating factor in patients with advanced malignancy. Ann Intern Med. 1989; 110:357-64. http://www.ncbi.nlm.nih.gov/pubmed/2644886?dopt=AbstractPlus

129. Antin JH, Smith BR, Holmes W et al. Phase I/II study of recombinant human granulocyte-macrophage colony-stimulating factor in aplastic anemia and myelodysplastic syndrome. Blood. 1988; 72:705-13. http://www.ncbi.nlm.nih.gov/pubmed/3042046?dopt=AbstractPlus

131. Cebon J, Nicola N, Ward M et al. Granulocyte-macrophage colony stimulating factor from human lymphocytes. J Biol Chem. 1990; 265:4483-91. http://www.ncbi.nlm.nih.gov/pubmed/2155231?dopt=AbstractPlus

132. Clark SC, Kamen R. The human hematopoietic colony-stimulating factors. Science. 1987; 236:1229-37. http://www.ncbi.nlm.nih.gov/pubmed/3296190?dopt=AbstractPlus

134. Vadhan-Raj S, Buescher S, Broxmeyer HE et al. Stimulation of myelopoiesis in patients with aplastic anemia by recombinant human granulocyte-macrophage colony-stimulating factor. N Engl J Med. 1988; 319:1628-34. http://www.ncbi.nlm.nih.gov/pubmed/3059191?dopt=AbstractPlus

136. Pluda JM, Yarchoan R, Smith PD et al. Subcutaneous recombinant granulocyte-macrophage colony-stimulating factor used as a single agent and in an alternating regimen with azidothymidine in leukopenic patients with severe human immunodeficiency virus infection. Blood. 1990; 76:463-72. http://www.ncbi.nlm.nih.gov/pubmed/2198957?dopt=AbstractPlus

138. Groopman JE, Mitsuyasu RT, DeLeo MJ et al. Effect of recombinant human granulocyte-macrophage colony-stimulating factor on myelopoiesis in the acquired immunodeficiency syndrome. N Engl J Med. 1987; 317:593-8. http://www.ncbi.nlm.nih.gov/pubmed/3497344?dopt=AbstractPlus

139. Kurzrock R, Talpaz M, Gutterman JU. Very low doses of GM-CSF administered alone or with erythropoietin in aplastic anemia. Am J Med. 1992; 93:41-8. http://www.ncbi.nlm.nih.gov/pubmed/1626572?dopt=AbstractPlus

140. Park LS, Friend D, Gillis S et al. Characterization of the cell-surface receptor for human granulocyte/macrophage colony-stimulating factor. J Exp Med. 1986; 164:251-62. http://www.ncbi.nlm.nih.gov/pubmed/3014035?dopt=AbstractPlus

141. Gearing DP, King JA, Gough NM et al. Expression cloning of a receptor for human granulocyte-macrophage colony-stimulating factor. EMBO J. 1989; 8:3667-76. http://www.ncbi.nlm.nih.gov/pubmed/2555171?dopt=AbstractPlus

142. Hayahida K, Kitamura T, Gorman DM et al. Molecular cloning of a second subunit of the receptor for human granulocyte-macrophage colony-stimulating factor (GM-CSF): reconstitution of a high-affinity GM-CSF receptor. Proc Natl Acad Sci. 1990; 87:9655-9. http://www.ncbi.nlm.nih.gov/pubmed/1702217?dopt=AbstractPlus

144. Saarinen UM, Hovi L, Riikonen P et al. Recombinant human granulocyte-macrophage colony-stimulating factor in children with chemotherapy-induced neutropenia. Med Pediatr Oncol. 1992; 20:489-96. http://www.ncbi.nlm.nih.gov/pubmed/1435519?dopt=AbstractPlus

149. Hewitt RG, Morse GD, Lawrence WD et al. Pharmacokinetics and pharmacodynamics of granulocyte-macrophage colony-stimulating factor and zidovudine in patients with AIDS and severe AIDS-related complex. Antimicrob Agents Chemother. 1993; 512-22.

150. Demetri DG, Antman KHS. Granulocyte-macrophage colony-stimulating factor (GM-CSF): preclinical and clinical investigations. Semin Oncol. 1992; 19:362-85. http://www.ncbi.nlm.nih.gov/pubmed/1509275?dopt=AbstractPlus

151. Vadhan-Raj S. Broxmeyer JE, Hittelman WN. Use of granulocyte-macrophage colony-stimulating factor in hematopoietic disorders: biology and nature of response. Semin Hematol. 1992; 29(Suppl 3):4-13. http://www.ncbi.nlm.nih.gov/pubmed/1492234?dopt=AbstractPlus

154. Shadduck RK. Granulocyte-macrophage colony-stimulating factor: present use and future directions. Semin Hematol. 1992; 29(Suppl 3):38-42. http://www.ncbi.nlm.nih.gov/pubmed/1492233?dopt=AbstractPlus

156. Kutsogiannis DJ, Crowther MA, Lazarovits AI. Granulocyte macrophage colony-stimulating factor for the therapy of cytomegalovirus and ganciclovir-induced leukopenia in a renal transplant recipient. Transplantation. 1992; 53: 930-1. http://www.ncbi.nlm.nih.gov/pubmed/1314441?dopt=AbstractPlus

158. Scadden DT. The clinical applications of colony-stimulating factors in acquired immunodeficiency syndrome. Semin Hematol. 1992; 29:33-7. http://www.ncbi.nlm.nih.gov/pubmed/1492232?dopt=AbstractPlus

159. Gill PS, Bernstein-Singer M, Espina BM et al. Adriamycin, bleomycin and vincristine chemotherapy with recombinant granulocyte-macrophage colony-stimulating factor in the treatment of AIDS-related Kaposi’s sarcoma. AIDS. 1992; 6:1477-81. http://www.ncbi.nlm.nih.gov/pubmed/1283520?dopt=AbstractPlus

160. Walsh C, Wernz JC, Levine A et al. Phase I trial of m-BACOD and granulocyte macrophage colony-stimulating factor in HIV-associated non-Hodgkin’s lymphoma. J Acquir Immune Defic Syndr. 1993; 6:265-71. http://www.ncbi.nlm.nih.gov/pubmed/7680712?dopt=AbstractPlus

161. Groopman JE, Feder D. Hematopoietic growth factors in AIDS. Semin Oncol. 1992; 19:408-14. http://www.ncbi.nlm.nih.gov/pubmed/1380730?dopt=AbstractPlus

162. Gerhartz HH, Stern AC, Wolf-Hornung B et al. Intervention treatment of established neutropenia with human recombinant granulocyte-macrophage colony-stimulating factor (rhGM-CSF) in patients undergoing cancer chemotherapy. Leuk Res. 1993; 17:175-85. http://www.ncbi.nlm.nih.gov/pubmed/8429694?dopt=AbstractPlus

163. Miwa S, Shibata A, Kaneko T et al. Phase I/II study of recombinant human granulocyte-macrophage colony-stimulating factor in patients with advanced malignancy. Acta Haematol. 1992; 87:22-8. http://www.ncbi.nlm.nih.gov/pubmed/1585768?dopt=AbstractPlus

164. Ajani JA, Roth JA, Ryan B et al. Intensive preoperative chemotherapy with colony-stimulating factor for resectable adenocarcinoma of the esophagus or gastroesophageal junction. J Clin Oncol. 1993; 11:22-8. http://www.ncbi.nlm.nih.gov/pubmed/8418237?dopt=AbstractPlus

165. Gianni AM, Bregni M, Siena S et al. Granulocyte-macrophage colony-stimulating factor or granulocyte colony-stimulating factor infusion makes high-dose etoposide a safe outpatient regimen that is effective in lymphoma and myeloma patients. J Clin Oncol. 1992; 10:1055-62.

166. Kantarjian HM, Estey EH, O’Brien S et al. Intensive chemotherapy with mitoxantrone and high-dose cytosine arabinoside followed by granulocyte-macrophage colony-stimulating factor in the treatment of patients with acute lymphocytic leukemia. Blood. 1992; 79:876-81. http://www.ncbi.nlm.nih.gov/pubmed/1737098?dopt=AbstractPlus

167. Edmonson JH, Hartmann LC, Long HJ et al. Granulocyte-macrophage colony-stimulating factor. Cancer. 1992; 70:2529-39. http://www.ncbi.nlm.nih.gov/pubmed/1423182?dopt=AbstractPlus

169. Clark DA, Neidhart JA. Granulocyte-macrophage colony-stimulating factor with dose-intensified treatment of cancer. Semin Hematol. 1992; 29(Suppl 3):27-32. http://www.ncbi.nlm.nih.gov/pubmed/1492231?dopt=AbstractPlus

172. Gradishar WJ, Le Beau MM, O’Laughlin R et al. Clinical and cytogenetic responses to granulocyte-macrophage colony-stimulating factor in therapy-related myelodysplasia. Blood. 1992; 80:2463-70. http://www.ncbi.nlm.nih.gov/pubmed/1421369?dopt=AbstractPlus

173. Singer JW. Role of colony-stimulating factors in bone marrow transplantation. Semin Oncol. 1992; 19:27-31. http://www.ncbi.nlm.nih.gov/pubmed/1615330?dopt=AbstractPlus

174. Armitage JO. The use of granulocyte-macrophage colony-stimulating factor in bone marrow transplantation. Semin Hematol. 1992; 29(Suppl 3):14-8. http://www.ncbi.nlm.nih.gov/pubmed/1362821?dopt=AbstractPlus

175. Fabian I, Shapira E, Gadish M et al. Effects of human interleukin 3, macrophage and granulocyte-macrophage colony-stimulating factor on monocyte function following autologous bone marrow transplantation. Leuk Res. 1992; 16:703-9. http://www.ncbi.nlm.nih.gov/pubmed/1321933?dopt=AbstractPlus

178. Kaiser U, Klausmann M, Kolb G et al. Felty’s syndrome: favorable response to granulocyte-macrophage colony-stimulating factor in the acute phase. Acta Haematol. 1992; 87:190-4. http://www.ncbi.nlm.nih.gov/pubmed/1519433?dopt=AbstractPlus

179. Bjorkhom M, Pisa P, Arver S et al. Haematologic effects of granuloctye-macrophage colony stimulating factor in a patient with thiamazole-induced agranulocytosis. J Intern Med. 1992; 232:443-5. http://www.ncbi.nlm.nih.gov/pubmed/1453130?dopt=AbstractPlus

180. Rospond RM, Glowacki RC, Mailliard JA. Sargramostim for sulfasalazine-induced agranulocytosis. Clin Pharm. 1993; 12:179. http://www.ncbi.nlm.nih.gov/pubmed/8098278?dopt=AbstractPlus

182. Newman SL, Gootee L. Colony-stimulating factors activate human macrophages to inhibit intracellular growth of Histoplasma capsulatum yeasts. Infect Immun. 1992; 60:4593-7. http://www.ncbi.nlm.nih.gov/pubmed/1398972?dopt=AbstractPlus

184. Hovgaard DJ, Nissen NI. Effect of recombinant human granulocyte-macrophage colony-stimulating factor in patients with Hodgkin’s disease: a phase I/II study. J Clin Oncol. 10:390-7.

185. Raychaudhuri SP, Fiore MM. Clearance of unremitting psoriasis after treatment with granulocyte-macrophage colony-stimulating factor. J Am Acad Derm. 1992; 27:451-2. http://www.ncbi.nlm.nih.gov/pubmed/1401283?dopt=AbstractPlus

186. Hess U, Ganser A, Schnuech HG et al. Myelokathexis treated with recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF). Br J Haematol. 1992; 80:254-6. http://www.ncbi.nlm.nih.gov/pubmed/1550786?dopt=AbstractPlus

187. Orazi A, Cattoretti G, Schiro R et al. Recombinant human interleukin-3 and recombinant human granulocyte-macrophage colony-stimulating factor administered in vivo after high-dose cyclophosphamide cancer chemotherapy: effect on hematopoiesis and microenvironment in human bone marrow. Blood. 1992; 79:2610-9. http://www.ncbi.nlm.nih.gov/pubmed/1586713?dopt=AbstractPlus

188. Chasen MR, Sarembock B, Meyers OL. Successful treatment of gold-induced aplastic anaemia with granulocyte macrophage colony stimulating factor. Br J Rheumatol. 1992; 31:428-9. http://www.ncbi.nlm.nih.gov/pubmed/1596710?dopt=AbstractPlus

189. Nimer SD. The use of colony-stimulating factors in primary hematalogic disorders. Cancer. 1992; 70(Suppl 4):921-7. http://www.ncbi.nlm.nih.gov/pubmed/1638464?dopt=AbstractPlus

190. Folk SM, Tefferi A. Letter to the editor: granulocyte-macrophage colony-stimulating factor for the treatment of neutropenia associated with large granular lymphocytic leukemia. Am J Hematol. 1992; 39:316. http://www.ncbi.nlm.nih.gov/pubmed/1553964?dopt=AbstractPlus

196. Rabinowe SN, Neuberg D, Bierman PJ et al. Long-term follow-up of a phase III study of recombinant human granulocyte-macrophage colony-stimulating factor after autologous bone marrow transplantation for lymphoid malignancies. Blood. 1993; 81:1903-8. http://www.ncbi.nlm.nih.gov/pubmed/8461475?dopt=AbstractPlus

198. Vadhan-Raj S, Broxmeyer HE, Hittelman WN et al. Abrogating chemotherapy-induced myelosuppression by recombinant granulocyte- macrophage colony-stimulating factor in patients with sarcoma: protection at the progenitor cell level. J Clin Oncol. 1992; 10:1266-77. http://www.ncbi.nlm.nih.gov/pubmed/1634916?dopt=AbstractPlus

199. Neidhart JA, Mangalik A, Stidley CA et al. Dosing regimen of granulocyte-macrophage colony-stimulating factor to support dose-intensive chemotherapy. J Clin Oncol. 1992; 10:1460- 9. http://www.ncbi.nlm.nih.gov/pubmed/1517789?dopt=AbstractPlus

200. Perno CF, Cooney DA, Gao WY et al. Effects of bone marrow stimulatory cytokines on human immunodeficiency virus replication and the antiviral activity of dideoxynucleosides in cultures of monocyte/macrophages. Blood. 1992; 80: 995-1003. http://www.ncbi.nlm.nih.gov/pubmed/1379854?dopt=AbstractPlus

202. Williams DE, Bicknell DC, Park LS et al. Purified murine granulocyte/macrophage progenitor cells express a high-affinity receptor for recombinant murine granulocyte-macrophage colony-stimulating factor. Proc Natl Acad Sci. 1988; 85:487-91. http://www.ncbi.nlm.nih.gov/pubmed/2829188?dopt=AbstractPlus

205. Hardy WD. Combined ganciclovir and recombinant human granulocyte-macrophage colony-stimulating factor in the treatment of cytomegalovirus retinitis in AIDS patients. J Acquir Immune Defic Syndr. 1991; 4(Suppl 1):S22-8. http://www.ncbi.nlm.nih.gov/pubmed/1848618?dopt=AbstractPlus

215. Griffin JD, Young D, Herrmann F et al. Effects of recombinant human GM-CSF on proliferation of clonogenic cells in acute myeloblastic leukemia. Blood. 1986; 67:1448-53. http://www.ncbi.nlm.nih.gov/pubmed/3486012?dopt=AbstractPlus

216. Vellenga E, Young DC, Wagner K et al. The effects of GM-CSF and G-CSF in promoting growth of clonogenic cells in acute myeloblastic leukemia. Blood. 1987; 69:1771-6. http://www.ncbi.nlm.nih.gov/pubmed/3495305?dopt=AbstractPlus

217. Anon. Drugs for AIDS and associated infections. Med Lett Drugs Ther. 1993; 35:79-86. http://www.ncbi.nlm.nih.gov/pubmed/8394503?dopt=AbstractPlus

219. Ross SD, DiGeorge A, Connelly JE et al. Safety of GM-CSF in patients with AIDS: a review of the literature. Pharmacotherapy. 1998; 18:1290-7. http://www.ncbi.nlm.nih.gov/pubmed/9855329?dopt=AbstractPlus

220. Rowe JN, Andersen JW, Mazza JJ et al. A randomized placebo-controlled phase III study of granulocyte-macrophage colony-stimulating factor in adult patients (>55 to 70 years of age) with acute myelogenous leukemia: a study of the Eastern Cooperative Oncology Group (E1490). Blood. 1995; 86:457-62. http://www.ncbi.nlm.nih.gov/pubmed/7605984?dopt=AbstractPlus

223. Nemunaitis J, Rosenfeld CS, Ash R et al. Phase III randomized, double-blind placebo-controlled trial of rhGM-CSF following allogeneic bone marrow transplantation. Bone Marrow Transplant. 1995; 72:949-54.

229. Angel JB, High K, Rhame F et al. Phase III study of granulocyte-macrophage colony-stimulating factor in advanced HIV disease: effect on infections, CD4 cell counts and HIV suppression. Leukine/HIV Study Group. AIDS. 2000; 14:387-95. http://www.ncbi.nlm.nih.gov/pubmed/10770541?dopt=AbstractPlus

231. Wong RJ. Treatment of HIV-related neutropenia. Am J Health Syst Pharm. 1999; 56(Suppl 5):S17-20. http://www.ncbi.nlm.nih.gov/pubmed/10613382?dopt=AbstractPlus

235. Hodi FS, Lee S, McDermott DF, et al. Ipilimumab plus sargramostim vs ipilimumab alone for treatment of metastatic melanoma. JAMA. 2014;312:1744-53.

236. Roth L, MacDonald JK, McDonald JWD, Chande N. Sargramostim (GM-CSF) for induction of remission in Crohn’s disease. Cochrane Database Syst Rev. 2011;11:CD008538.

237. Li J, Liu W, Zhang G, et al. Effectiveness of recombinant human granulocyte macrophage colony-stimulating factor for treating deep second-degree burns: a systematic review and meta-analysis. BMJ Mil Health. 2020;166:352-7.

238. Smith TJ, Bohlke K, Lyman GH, et al. Recommendations for the use of WBC growth factors: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2015;33:3199-212.

239. Crawford J, Becker PS, Armitage JO, et al. Myeloid growth factors. Version 2.2017. Clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2017;15:1520-41.

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