Southwestern Internal Medicine Conference: clinical use of hematopoietic growth factors.
The hematopoietic growth factors, granulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor (GM-CSF), have been cloned, produced in bacteria and yeast, and approved for clinical use in the treatment of neutropenia. Both factors stimulate the proliferation and maturation of neutrophil progenitors and enhance the effector functions of mature cells by interaction with specific receptors on the cell surface. Serum levels of G-CSF correlate inversely with the neutrophil count, suggesting that G-CSF may be the normal homeostatic regulator of the neutrophil count, while GM-CSF is generally undetectable in the serum and appears under normal physiologic conditions to act locally at inflammatory sites. Phase I and II clinical trials with these factors demonstrated minimal toxicity for G-CSF and mild to moderate dose-dependent toxicity for GM-CSF. Recent clinical trials, including double-blind, randomized studies, support a role for these growth factors in the treatment of chronic neutropenias, such as Kostmann's syndrome, acquired immune deficiency syndrome (AIDS), aplastic anemia, and myelodysplasia, as well as in acute neutropenias, such as cyclic neutropenia, chemotherapy-induced neutropenia, and bone marrow transplantation.
Fleischman
R A
RA
Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas 75235-8852.
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy; D000741:Anemia, Aplastic / Q000188:drug therapy; D001483:Base Sequence; D001853:Bone Marrow / Q000187:drug effects; D016026:Bone Marrow Transplantation; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects / Q000737:chemistry / Q000502:physiology / Q000627:therapeutic use*; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000009:adverse effects / Q000737:chemistry / Q000502:physiology / Q000627:therapeutic use*; D006801:Humans; D008969:Molecular Sequence Data; D009190:Myelodysplastic Syndromes / Q000188:drug therapy; D009503:Neutropenia / Q000188:drug therapy*; D016188:Receptors, Granulocyte Colony-Stimulating Factor / Q000032:analysis; D016187:Receptors, Granulocyte-Macrophage Colony-Stimulating Factor / Q000032:analysis
D016188:Receptors, Granulocyte Colony-Stimulating Factor; D016187:Receptors, Granulocyte-Macrophage Colony-Stimulating Factor; D016179:Granulocyte Colony-Stimulating Factor; D016178:Granulocyte-Macrophage Colony-Stimulating Factor