title: Hematopoietic management in oncology practice. Part 1. Myeloid growth factors.
abstract: Hematopoietic growth factors have transformed the practice of oncology. The two major factors in clinical use are recombinant human (rh) granulocyte colony-stimulating factor (G-CSF, filgrastin [Neupogen]) and granulocyte-macrophage colony-stimulating factor (GM-CSF, sargramostim [Leukine]). These factors differ significantly in their role in hematopoiesis and the regulation of mature effector cell function. G-CSF regulates both basal and neutrophil production and increased production and release of neutrophils from the marrow in response to infection. GM-CSF mediates its effects on the neutrophil lineage through its effects on phagocytic accessory cells and its synergy with G-CSF, but it does not appear to have a role in basal hematopoiesis. Part 1 of this two-part series focuses on the use of the myeloid growth factors rhG-CSF and rhGM-CSF to shorten the duration of chemotherapy-induced neutropenia and thus prevent infection in cancer patients. In randomized trials, rhG-CSF has consistently decreased the duration of neutropenia during all cycles of chemotherapy and reduced the risk of infection by 50% or more. Trials of rhGM-CSF have not reported consistent results.
authors.affiliation: Division of Hematology/Oncology, UCLA School of Medicine, Los Angeles, California, USA. jglaspy@mednet.ucla.edu
authors.forename: John A
authors.initials: JA
authors.lastname: Glaspy
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D006410:Hematopoiesis / Q000187:drug effects; D006801:Humans; D007239:Infections / Q000209:etiology; D009369:Neoplasms / Q000150:complications*; D009503:Neutropenia / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D011994:Recombinant Proteins
chemical_list: D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D016178:Granulocyte-Macrophage Colony-Stimulating Factor