Clinical use of hematopoietic growth factors for control of infections after high-dose chemotherapy.
Hematopoietic growth factors are being used to accelerate the recovery of myelopoiesis following high-dose chemotherapy in cancer patients. G-CSF and GM-CSF reduce the duration of neutropenia following chemotherapy. Rapid restoration of neutrophils has been associated with reduced incidence of neutropenic fever and documented infections and fewer days of intravenous antibiotics and hospitalization. Recent studies suggest that combinations of cytokines may further expand the hematopoietic cell populations, which may be particularly useful following myeloablative chemotherapy, when thrombocytopenia may be a dose-limiting toxicity. For example, IL-3, which stimulates early progenitor cells, has definite but inconsistent effects on increasing neutrophil and platelet counts. However, in combination with later-acting cytokines (e.g., GM-CSF and IL-6), recovery from both thrombocytopenia and neutropenia is accelerated. As dose escalation of chemotherapy becomes more widely practiced, the role of cytokine combinations will become increasingly important.
Felser
J M
JM
Cytokine Development Unit, Sandoz Pharmaceuticals Corporation, East Hanover, New Jersey 07936.
D000970:Antineoplastic Agents / Q000008:administration & dosage*; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage*; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000008:administration & dosage*; D006410:Hematopoiesis / Q000187:drug effects*; D016298:Hematopoietic Cell Growth Factors / Q000494:pharmacology*; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007377:Interleukin-3 / Q000008:administration & dosage*; D011994:Recombinant Proteins
D000970:Antineoplastic Agents; D016298:Hematopoietic Cell Growth Factors; D007377:Interleukin-3; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D016178:Granulocyte-Macrophage Colony-Stimulating Factor