| Acute lymphocytic leukemia

Leukine vs Rituxan

Side-by-side clinical, coverage, and cost comparison for acute lymphocytic leukemia.

Deep comparison between: Leukine vs Rituxan with Prescriber.AI

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Safety signalsRituxan has a higher rate of injection site reactions vs Leukine based on FDA-approved prescribing information

Coverage gaps3 major payers require step therapy for Rituxan but not Leukine, including UnitedHealthcare

Category

Leukine

Rituxan

At A Glance

RouteIV infusion or SC injection

FrequencyOnce daily

ClassGM-CSF

RouteIV infusion

ClassAnti-CD20 monoclonal antibody

Indications

Leukemia, Myelocytic, Acute
Lymphoma, Non-Hodgkin
Acute lymphocytic leukemia
Hodgkin Disease
Hematopoietic subsyndrome of acute radiation syndrome

Lymphoma, Non-Hodgkin
Chronic Lymphocytic Leukemia
Rheumatoid Arthritis
Granulomatosis with polyangiitis
Microscopic Polyarteritis
Pemphigus Vulgaris
Acute lymphocytic leukemia

Dosing

Leukemia, Myelocytic, Acute 250 mcg/m2/day IV over a 4-hour period starting day 11 or four days after induction chemotherapy completion; continue until ANC >1500 cells/mm3 for 3 consecutive days or up to 42 days.

Lymphoma, Non-Hodgkin, Acute lymphocytic leukemia, Hodgkin Disease 250 mcg/m2/day IV over 24 hours or SC once daily beginning immediately following progenitor cell infusion; continue until ANC >1500 cells/mm3 for three consecutive days.

Autologous or allogeneic bone marrow transplantation 250 mcg/m2/day IV over a 2-hour period beginning 2-4 hours after bone marrow infusion; continue until ANC >1500 cells/mm3 for three consecutive days.

Delayed neutrophil recovery or graft failure 250 mcg/m2/day for 14 days as a 2-hour IV infusion; may repeat after 7 days off therapy if neutrophil recovery has not occurred, up to three courses.

Hematopoietic subsyndrome of acute radiation syndrome SC injection once daily: 7 mcg/kg for adults and pediatric patients >40 kg, 10 mcg/kg for pediatric patients 15-40 kg, 12 mcg/kg for pediatric patients <15 kg; continue until ANC >1000/mm3 for three consecutive CBCs.

Lymphoma, Non-Hodgkin 375 mg/m2 IV; weekly for 4 or 8 doses for relapsed/refractory low-grade or follicular NHL; Day 1 of each chemotherapy cycle for up to 8 doses for previously untreated follicular or DLBCL; every 8 weeks for 12 doses as single-agent maintenance.

Acute lymphocytic leukemia 375 mg/m2 IV for 6 total infusions in combination with LMB chemotherapy (two doses during each of the two induction courses, one dose during each of the two consolidation courses) for pediatric patients aged 6 months and older.

Chronic Lymphocytic Leukemia 375 mg/m2 IV the day prior to initiation of cycle 1 FC chemotherapy, then 500 mg/m2 on Day 1 of cycles 2-6 every 28 days.

Rheumatoid Arthritis Two 1,000 mg IV infusions separated by 2 weeks per course in combination with methotrexate; subsequent courses every 24 weeks (no sooner than 16 weeks); premedicate with methylprednisolone 100 mg IV 30 minutes prior to each infusion.

Granulomatosis with polyangiitis, Microscopic Polyarteritis Induction: 375 mg/m2 IV once weekly for 4 weeks with glucocorticoids; follow-up: two 500 mg IV infusions separated by 2 weeks, then 500 mg IV every 6 months based on clinical evaluation.

Pemphigus Vulgaris Two 1,000 mg IV infusions separated by 2 weeks in combination with a tapering course of glucocorticoids; then 500 mg IV at Month 12 and every 6 months thereafter or based on clinical evaluation.

Contraindications

History of serious allergic reactions, including anaphylaxis, to sargramostim, yeast-derived products, or any component of the product

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Drug Interactions

5View drug interactions

537View drug interactions

Adverse Reactions

Most common (>=10%) Fever, nausea, diarrhea, vomiting, rash, alopecia, stomatitis, asthenia, malaise, anorexia, edema, headache, chills, peripheral edema, dyspnea

Serious Hypersensitivity and anaphylaxis, infusion-related reactions, severe myelosuppression, effusions, capillary leak syndrome, supraventricular arrhythmias, leukocytosis

Postmarketing Infusion-related reactions, serious allergic reactions including anaphylaxis, effusions, capillary leak syndrome, supraventricular arrhythmias, leukocytosis including eosinophilia, thromboembolic events, injection site reactions

Most common (>=25%) Infusion-related reactions, fever, lymphopenia, chills, infection, asthenia (in NHL); infusion-related reactions, neutropenia (in CLL)

Serious Fatal infusion-related reactions, severe mucocutaneous reactions, hepatitis B reactivation with fulminant hepatitis, progressive multifocal leukoencephalopathy, tumor lysis syndrome, sepsis, cardiovascular events, renal toxicity, bowel obstruction and perforation

Postmarketing Prolonged pancytopenia, fatal cardiac failure, progressive multifocal leukoencephalopathy, severe mucocutaneous reactions, pyoderma gangrenosum, bowel obstruction and perforation, fatal bronchiolitis obliterans, fatal interstitial lung disease, posterior reversible encephalopathy syndrome

Pharmacology

Sargramostim (GM-CSF) is a colony-stimulating factor that supports survival, clonal expansion, and differentiation of hematopoietic progenitor cells, inducing partially committed progenitors to divide and differentiate into granulocyte-macrophage pathways including neutrophils, monocytes/macrophages, and myeloid-derived dendritic cells; it can also activate mature granulocytes and macrophages and promote proliferation of megakaryocytic and erythroid progenitors.

Rituximab is a chimeric murine/human IgG1 kappa monoclonal antibody that binds the CD20 antigen on pre-B and mature B-lymphocytes, mediating B-cell lysis via complement dependent cytotoxicity (CDC) and antibody dependent cell mediated cytotoxicity (ADCC).

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Most Common Insurance

Anthem BCBS

Leukine