title: Hematopoietic growth factors including keratinocyte growth factor in allogeneic and autologous stem cell transplantation.
abstract: The aim of hematopoietic stem cell transplantation (HSCT) is to cure patients of malignancies, autoimmune diseases, and immunodeficiency disorders by redirecting the immune system: the often described graft-versus-leukemia (GVL) or graft-versus-tumor (GVT) effects. Unfortunately, fulfillment of this goal is often hampered by relapse of the underlying disease, graft-versus-host disease (GVHD), or severe opportunistic infections, which account for the majority of post-transplantation deaths. Moreover, studies of long-term survivors of transplantation indicate an accelerated immune aging due to the transplantation procedure itself, preceding chemo- or radiotherapy, and acute and chronic GVHD. Significant advances have been made towards overcoming these obstacles by enhancing immune reconstitution with hematopoietic growth factors (HGFs) such as granulocyte colony-stimulating factor (G-CSF) or erythropoietin (EPO) or through the application of cytokines. In addition, there are approaches to promote the thymic-dependent development of naive T cells, which are prepared for the interaction with a multitude of pathogens. Examples are the application of keratinocyte growth factor (KGF), neuroendocrine hormones such as growth hormone or prolactin, sex hormone ablation, or the invention of a three-dimensional artificial thymus based on a cytomatrix. Might these measures result in a higher rate of healthy and fully recovered patients? Here we review progress in each of these areas.
authors.affiliation: Department of Internal Medicine II, Julius-Maximilians-University, Würzburg, Germany.
authors.forename: Ruth
authors.initials: R
authors.lastname: Seggewiss
authors.forename: Hermann
authors.initials: H
authors.lastname: Einsele
mesh_terms: D000818:Animals; D001327:Autoimmune Diseases / Q000628:therapy; D051523:Fibroblast Growth Factor 7 / Q000097:blood / Q000276:immunology / Q000627:therapeutic use*; D006086:Graft vs Host Disease / Q000097:blood / Q000150:complications / Q000276:immunology*; D016179:Granulocyte Colony-Stimulating Factor / Q000097:blood / Q000276:immunology / Q000627:therapeutic use; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000097:blood / Q000627:therapeutic use; D016298:Hematopoietic Cell Growth Factors / Q000627:therapeutic use*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D007107:Immune System / Q000502:physiology; D009369:Neoplasms / Q000628:therapy; D013950:Thymus Gland / Q000276:immunology*; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous
chemical_list: D016298:Hematopoietic Cell Growth Factors; D051523:Fibroblast Growth Factor 7; D016179:Granulocyte Colony-Stimulating Factor; D016178:Granulocyte-Macrophage Colony-Stimulating Factor