Haemopoietic growth factors for neonates: assessing risks and benefits.
This review summarises the rationale, clinical trial evidence for benefit and potential toxicities of Erythropoietin, Thrombopoietin, Granulocyte Colony Stimulating Factor and Granulocyte-Macrophage Colony Stimulating Factor. Erythropoietin has failed to have a clinical impact on red cell transfusion requirement in very low birth weight infants; it is uncertain whether Thrombopoietin will find a significant clinical role in neonatal thrombocytopenia and there is, as yet, insufficient evidence for the routine use of Granulocyte- or Granulocyte-Macrophage Colony Stimulating Factor to prevent or treat bacterial infection. A number of theoretical risks of haemopoietic growth factor use in neonates have been suggested, but no toxicities have been observed during their clinical use. Exploring the potential for benefit in selected groups of infants should be encouraged.
Carr
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Department of Haematology, King's College, Guy's Hospital Campus, London, UK. robert.carr@gstt.sthames.nhs.uk
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D004921:Erythropoietin / Q000009:adverse effects / Q000627:therapeutic use; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects / Q000627:therapeutic use; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000009:adverse effects / Q000627:therapeutic use; D016298:Hematopoietic Cell Growth Factors / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007231:Infant, Newborn; D007938:Leukemia / Q000139:chemically induced*; D013926:Thrombopoietin / Q000009:adverse effects / Q000627:therapeutic use
D016298:Hematopoietic Cell Growth Factors; D004921:Erythropoietin; D016179:Granulocyte Colony-Stimulating Factor; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D013926:Thrombopoietin