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# Sargramostim

Recombinant GM-CSF that stimulates granulocytes and monocytes, used to speed marrow recovery after transplantation and some chemotherapy.

Updated 2026-11-01

- Class: [Myeloid colony-stimulating factors](https://durgical.com/en/pharmacology/classes/myeloid-colony-stimulating-factors/)
- Receptor: GM-CSF receptor (α subunit with the common β chain)
- ATC code: L03AA09

Also called: recombinant granulocyte-macrophage colony-stimulating factor (GM-CSF)

◎**GM-CSF receptor (α subunit with the common β chain)**Sargramostim

ⓘ 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.

**Target in 3D:** GM-CSF receptor (α subunit with the common β chain). PDB structure 4NKQ (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/4NKQ) · Drag to rotate · pinch to zoom

## 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

### Serious (rare, important)

- Capillary leak with oedema and pleural or pericardial effusions
- First-dose reaction: flushing, hypotension, breathlessness and low oxygen saturation
- Fast or irregular heartbeat

## 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.

## Memory aid

GM = «Gets More»: more cell lines, more fever, more leak than G-CSF.

## 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.

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## Related drugs

- [Filgrastim](https://durgical.com/en/pharmacology/filgrastim/)

[← Back to the class: Myeloid colony-stimulating factors](https://durgical.com/en/pharmacology/classes/myeloid-colony-stimulating-factors/)

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](https://medlineplus.gov/druginfo/meds/a693005.html) (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](https://atcddd.fhi.no/atc_ddd_index/?code=L03AA09) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/sargramostim/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/sargramostim/