[Hematopoietic growth factors and autologous or allogeneic stem cell transplantation].
Hematopoietic growth factors are usually administered in autologous and allogeneic stem cell transplantation. RhuG-CSF and rhuEPO are the most frequently used, either for mobilization of peripheral stem cells or after transplantation for the improvement of hematologic recovery. G-CSF (filgrastim or lenograstim) can be administered alone or in combination with stem cell factor to enhance stem cells mobilization. IL-3 and sargramostim are not used anymore. The protocol of administration of rhuG-CSF is well established. Furthermore, stem cell transplantation with peripheral cells is less expensive than with bone marrow. RhuEPO (erythropoietin) is not effective in mobilization. After transplantation, filgrastim or lenograstim can shorten the neutropenic period and decrease infectious complications. The potential effect of these growth factors on the incidence and the severity of GvHD is still unknown and under debate. The use of rhuEPO after transplantation might be of interest to reduce the need of red blood cell transfusion. Some studies suggest that the administration of rhuEPO should start before delivering the conditioning regimen. The new long acting growth factors such as pegfilgrastim are still under evaluation and their use in mobilization seems promising.
Bay
Jacques-Olivier
JO
Unité de transplantation médullaire, Centre Jean-Perrin, 58, rue Montalembert, 63000 Clermont-Ferrand. olivier.bay@cjp.fr
Peffault de Latour
Régis
R
Tournilhac
Olivier
O
Choufi
Bachra
B
Chassagne
Jacques
J
D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects; D004921:Erythropoietin / Q000627:therapeutic use; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000627:therapeutic use; D016298:Hematopoietic Cell Growth Factors / Q000627:therapeutic use; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D000078224:Lenograstim; D007937:Leukapheresis; D009503:Neutropenia / Q000139:chemically induced / Q000188:drug therapy / Q000517:prevention & control*; D011092:Polyethylene Glycols; D011994:Recombinant Proteins / Q000627:therapeutic use
D000970:Antineoplastic Agents; D016298:Hematopoietic Cell Growth Factors; D011994:Recombinant Proteins; D004921:Erythropoietin; D016179:Granulocyte Colony-Stimulating Factor; C455861:pegfilgrastim; D011092:Polyethylene Glycols; C081222:sargramostim; D000078224:Lenograstim; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D000069585:Filgrastim