Pharmacology · Myeloid colony-stimulating factors
Sargramostim !
Recombinant GM-CSF that stimulates granulocytes and monocytes, used to speed marrow recovery after transplantation and some chemotherapy.
Updated 2026-11-01
Also called: recombinant granulocyte-macrophage colony-stimulating factor (GM-CSF)
The figure shows human GM-CSF bound to the α subunit and the common β chain of its receptor; sargramostim is a recombinant GM-CSF.
Mechanism of action
Sargramostim is recombinant human GM-CSF. Through its receptor it stimulates the proliferation and maturation of progenitors of neutrophils, monocytes and eosinophils and activates mature cells. Its broader action explains more side effects than G-CSF.
- GM-CSF binds its receptor on myeloid progenitors
- Neutrophil, monocyte and eosinophil lines expand
- Marrow recovery after transplant is faster
Pharmacokinetics
- Absorption
- Subcutaneous or slow intravenous infusion
- Half-life
- A few hours after subcutaneous injection
Indications
- To speed myeloid recovery after autologous or allogeneic marrow transplantation
- To mobilise stem cells for collection, and to shorten neutropenia after intensive chemotherapy
Adverse effects
Common
- Fever, malaise, flu-like symptoms
- Bone, joint and muscle pain
- Diarrhoea, rash
Contraindications
- Serious allergy to sargramostim
- Caution with heart failure, fluid retention and lung disease
Key interactions
- Chemotherapy or radiotherapy at the same time
- Dividing myeloid cells would be more sensitive, so it is given after them
What is monitored
- Complete blood count, to avoid an excessive rise
- Weight, oedema and breathing (fluid retention)
- Blood pressure and oxygen saturation with the first dose
Administration and safety
- Subcutaneous injection or slow intravenous infusion
- Not given within the same period as chemotherapy or radiotherapy
Nursing care
- Observe closely during the first dose (flushing, hypotension, breathlessness)
- Daily weight and check for swelling
- Report fever, chills, cough or sore throat
Pregnancy and breastfeeding
Human data are limited; it is used in pregnancy only when the benefit justifies it.
Test yourself
Think of the answer, then tap the question to see it.
How does GM-CSF differ from G-CSF in its targets?
GM-CSF also stimulates monocytes and eosinophils; G-CSF acts mainly on neutrophils.
Which serious effect causes oedema and effusions?
Capillary leak syndrome.
What is its classic use?
Speeding myeloid recovery after marrow transplantation.
Related drugs
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Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Sargramostim: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2016); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 45 (McGraw Hill, 2023); Farmacología básica y clínica (Katzung), 16.ª ed., cap. 33 (McGraw Hill, 2025); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.