Biomodulation of chemotherapy-induced myelosuppression

Growth factors, or cytokines, that have a broad spectrum of actions on lymphoid and myeloid cell lineages recently have been introduced into clinical practice. Erythropoietin, granulocyte-colony stimulating factor, and granulocyte-macrophage-colony stimulating factor were the first to be introduced and to receive approval from the Food and Drug Administration. A number of interleukins and other cytokines presently are being developed. If a clinician is to use these potent biologicals appropriately, it is important that he or she understand the basic concepts of their biological actions and physiological effects. This article outlines features of production, cellular action, synergistic interactions, action on neoplastic cells, and clinical utility of these growth factors, all relating to their potential use in states of chemotherapy-induced myelosuppression.