Clinical use of haematopoietic growth factors

Over the past decade experimental haematologists have identified and eventually characterised a number of polypeptide growth factors capable of stimulating the proliferation and differentiation of haemopoietic progenitor cells in vitro. The molecular cloning of these growth factors has now allowed their use in vivo, and some of them have shown promise in recent clinical trials. Most of the work has been done on erythropoietin and myeloid growth factors, which are discussed in this review. Erythropoietin has been used successfully as replacement therapy in the anaemia of end-stage renal failure, but may also prove clinically useful in other chronic anaemias and, in combination with other growth factors, as a stimulant of bone marrow regeneration following bone marrow transplant. Myeloid growth factors, and, in particular, granulocyte colony-stimulating factor, have been shown to accelerate neutrophil recover in cancer patients following chemotherapy, with a reduction in the number of severe infections and mucositis.