| Acute lymphocytic leukemia
Leukine vs Rylaze
Side-by-side clinical, coverage, and cost comparison for acute lymphocytic leukemia.Deep comparison between: Leukine vs Rylaze with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsRylaze has a higher rate of injection site reactions vs Leukine based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Rylaze but not Leukine, including UnitedHealthcare
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Category
Leukine
Rylaze
At A Glance
IV infusion or SC injection
Once daily
GM-CSF
IM injection
Every 48 hours
Recombinant L-asparaginase
Indications
- Leukemia, Myelocytic, Acute
- Lymphoma, Non-Hodgkin
- Acute lymphocytic leukemia
- Hodgkin Disease
- Hematopoietic subsyndrome of acute radiation syndrome
- Acute lymphocytic leukemia
- Precursor cell lymphoblastic lymphoma
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.
Acute lymphocytic leukemia, Precursor cell lymphoblastic lymphoma 25 mg/m2 IM every 48 hours, or 25 mg/m2 IM on Monday and Wednesday mornings and 50 mg/m2 IM on Friday afternoon, as replacement for a long-acting asparaginase product; premedicate with acetaminophen, H-1 blocker, and H-2 blocker 30-60 minutes prior to administration.
Contraindications
- History of serious allergic reactions, including anaphylaxis, to sargramostim, yeast-derived products, or any component of the product
- History of serious hypersensitivity reactions to Erwinia asparaginase, including anaphylaxis
- History of serious pancreatitis during previous asparaginase therapy
- History of serious thrombosis during previous asparaginase therapy
- History of serious hemorrhagic events during previous asparaginase therapy
- Severe hepatic impairment
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 (>20%) Abnormal liver test, nausea, musculoskeletal pain, infection, fatigue, headache, febrile neutropenia, pyrexia, hemorrhage, stomatitis, abdominal pain, decreased appetite, drug hypersensitivity, hyperglycemia, diarrhea, pancreatitis, hypokalemia
Serious Febrile neutropenia, infection, drug hypersensitivity, pyrexia, nausea, dehydration, stomatitis, acute kidney injury, pancreatitis, diarrhea, viral infection
Postmarketing Veno-occlusive disease (VOD)
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.
Asparaginase erwinia chrysanthemi (recombinant)-rywn is a recombinant bacterial enzyme that catalyzes the conversion of L-asparagine to aspartic acid and ammonia, depleting plasma asparagine and killing leukemic cells that depend on exogenous asparagine for survival due to low asparagine synthetase expression.
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Most Common Insurance
Anthem BCBS
Leukine
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (6/12) · Qty limit (0/12)
Rylaze
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Leukine
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (0/8) · Qty limit (0/8)
Rylaze
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Leukine
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (1/3) · Qty limit (1/3)
Rylaze
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableCancerCare: Chemotherapy Induced Neutropenia
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
$10/fillfill
JazzCares Copay Program: RylazeCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.