Cytokines following SCT: indications and controversies

The use of G-CSF and GM-CSF has been shown to benefit patients undergoing autologous hematopoietic SCT (HSCT), mainly after autologous bone marrow transplantation. Their benefit in allogeneic transplant is not as pronounced and the use of growth factors in this patient group remains controversial due to conflicting reports of whether the use of growth factors increases the incidence of acute and chronic GvHD. The efficacy of EPO in HSCT patients is not well studied, but a reduction in the number of RBC transfusions has been shown in patients undergoing allogeneic transplant. Also the efficacy of thrombopoietic agents to date has not been demonstrated. One promising new approach to reduce the degree of mucositis is the use of recombinant keratinocyte growth factor.