Clinical use of hematopoietic growth factors in allogeneic bone marrow transplantation

Blood Rev. 1994 Sep;8(3):169-78. doi: 10.1016/0268-960x(94)90078-v.

Abstract

The use of the recombinant hematopoietic growth factors G-CSF and GM-CSF have shortened the period of neutropenia, or avoided this problem, in many cancer patients who have received cytotoxic therapy. Although these benefits have been particularly striking in the autologous bone marrow and/or autologous peripheral blood progenitor cell transplant setting, most data suggest that the use of G-CSF and GM-CSF only marginally enhance recovery of the neutrophil count when administered after allogeneic bone marrow infusion. Furthermore, in the allograft setting these expensive agents have not provided benefit in the form of enhanced platelet count recovery, lessening the incidence of graft-versus-host disease, or improvement in overall survival. These data do not justify routine widespread use of G-CSF and GM-CSF and suggest that these agents should be reserved for patients who experience delay in engraftment after allogeneic bone marrow infusion. Administration of erythropoietin, on the other hand, may reduce the need for homologous red blood cell transfusions, and may increase the safety margin for both the allogeneic bone marrow recipient and as well as the donor. Recombinant hematopoietic growth factors targetted specifically to enhance platelet recovery after transplantation (such as interleukin-3, interleukin-6, and interleukin-11) have shown promise after autotransplantation and after conventional dose chemotherapy, and likely will be evaluated in the allogeneic transplant patient.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Bone Marrow Transplantation*
  • Clinical Trials as Topic
  • Erythropoietin / therapeutic use
  • Graft Survival / drug effects
  • Graft vs Host Disease / prevention & control
  • Granulocyte Colony-Stimulating Factor / adverse effects
  • Granulocyte Colony-Stimulating Factor / therapeutic use*
  • Granulocyte-Macrophage Colony-Stimulating Factor / adverse effects
  • Granulocyte-Macrophage Colony-Stimulating Factor / therapeutic use*
  • Hematopoiesis / drug effects*
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Lymphocyte Depletion
  • Macrophage Colony-Stimulating Factor / adverse effects
  • Macrophage Colony-Stimulating Factor / therapeutic use
  • Neoplasms / blood
  • Neoplasms / therapy
  • Neutropenia / prevention & control
  • Recombinant Proteins / adverse effects
  • Recombinant Proteins / therapeutic use
  • Transplantation, Homologous
  • Treatment Outcome

Substances

  • Recombinant Proteins
  • Erythropoietin
  • Granulocyte Colony-Stimulating Factor
  • Macrophage Colony-Stimulating Factor
  • Granulocyte-Macrophage Colony-Stimulating Factor