CLINICAL APPLICATIONS OF HEMATOPOIETIC GROWTH FACTORS

Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.

CLINICAL APPLICATIONS OF HEMATOPOIETIC GROWTH FACTORS

Immunol Ser; 49:359-78 1990. Unique Identifier : AIDSLINE ICDB/92669152
Steward WP; Scarffe JH; Dexter TM; Testa NG; Dept. of Medical Oncology, Paterson Inst. for Cancer Res.,; Christie Hosp. and Holt Radium Inst., Manchester, UK

Abstract: Growth factors play a major role in the control of hemopoiesis. Recombinant DNA technology recently has allowed the production of sufficient amounts of five of these for use in clinical testing: erythropoietin, granulocyte-macrophage colony-stimulating factor (GM-CSF), granulocyte CSF (G-CSF), macrophage CSF, and interleukin 3. GM-CSF and G-CSF already have been used in clinical studies in humans. Clinical application of hematopoietic growth factors is reviewed, including experimental in vivo studies, clinical studies (erythropoietin, GM-CSF, and G-CSF), future clinical applications, and possible risks of hemopoietic growth factors. Numerous potential clinical applications of myeloid CSFs have been recognized including therapy for bone marrow failure (idiopathic, neoplastic, and iatrogenic), augmentation of recovery after bone marrow transplantation, reduction in duration and degree of leukopenia after chemotherapy, increase in granulocyte number and function (eg, in AIDS), therapy for established bacterial and fungal infections, improvement of host defense against infection after major trauma (eg, burns), therapy for leukemia by altering rates of self-reproduction and differentiation, and therapy for myodysplasia by increasing normal differentiation and reducing the blast population. Certain theoretical risks of these therapies exist. These are (1) diversion of cells from one lineage to another, thus creating a deficiency, such as causing reduced erythropoiesis while stimulating myelopoiesis; (2) stimulation of mature leukocytes to produce potentially toxic products (eg, prostaglandins, tumor necrosis factor, fibroblast growth factor, and interferon); and (3) combination of chemotherapy and CSF administration leading to bone marrow aplasia if the timing and extent of this treatment is not carefully considered. (53 Refs)

Keywords: Animal Clinical Trials Colony-Stimulating Factors/ADVERSE EFFECTS/*THERAPEUTIC USE Drug Evaluation Erythropoietin/ADVERSE EFFECTS/THERAPEUTIC USE Granulocyte Colony-Stimulating Factor/ADVERSE EFFECTS/THERAPEUTIC USE Granulocyte-Macrophage Colony-Stimulating Factor/ADVERSE EFFECTS/ THERAPEUTIC USE Hamsters Haplorhini Hematopoietic Cell Growth Factors/ADVERSE EFFECTS/*THERAPEUTIC USE Human Mice Neoplasms/DRUG THERAPY Risk Factors JOURNAL ARTICLE REVIEW
921230
M92C5367

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