A 4-year-old boy with acute lymphoblastic leukemia is admitted to the hospital to undergo allogeneic bone marrow transplantation. Two weeks after the conditioning regimen is started, he develops a temperature of 38.5°C (101.3°F). Laboratory studies show:
Hemoglobin 8 g/dL
Leukocyte count 1400/mm3
Segmented neutrophils 15%
Eosinophils 0.5%
Lymphocytes 84%
Monocytes 1%
Platelet count 110,000/mm3
Which of the following is the most appropriate pharmacotherapy for this patient?

Question

Quizplus · Accepted Answer

Eductional Objective: Granulocyte-macrophage colony-stimulating factor (GM-CSF) promotes proliferation and differentiation of progenitor cells of neutrophils, eosinophils, and monocytes/macrophages in the bone marrow. Moreover, it can activate mature granulocytes and macrophages and induce proliferation of megakaryocytic and erythroid progenitor cells. This patient with chemotherapy-induced severe febrile neutropenia, anemia, and thrombocytopenia would benefit most from treatment with recombinant GM-CSF (i.e., sargramostim).

A 4-Year-Old Boy with Acute Lymphoblastic Leukemia Is Admitted to the Hospital