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Related Concept Videos

Role of Hematopoietic Growth Factors01:28

Role of Hematopoietic Growth Factors

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Hematopoietic growth factors are molecules that regulate the differentiation rate of hematopoietic stem cells (HSCs). Erythropoietin (EPO), primarily produced by the kidneys, plays a crucial role in erythrocyte production. When oxygen levels in the blood are low, EPO is released into the bloodstream, reaching the bone marrow, where it stimulates HSCs to differentiate and mature into erythrocytes, which are vital for oxygen transport.
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Regulation of Hematopoietic Stem Cells01:01

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All blood and immune cells are produced from the multipotent hematopoietic stem cells (HSCs) by the process of hematopoiesis. However, they all have a limited life span. In addition, many are depleted in immune surveillance or combatting an injury or infection. This makes blood one of the most regenerative tissues. Hematopoiesis helps replenish these blood and immune cells, restoring the body's normal functioning. However, overproduction of blood and immune cells can make them cancerous or...
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Differentiation of Common Myeloid Progenitor Cells01:15

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Common myeloid progenitors (CMPs) are oligopotent cells that can differentiate into granulocytes and macrophages. Granulocytes and macrophages are essential for protecting the body against bacterial, viral, or fungal infections. They migrate from the bone marrow into the circulating blood to reach specific tissue sites where they differentiate and help in immune surveillance. However, they survive only for a few days and must be continuously made available to the organism to maintain a robust...
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Regulation of Angiogenesis and Blood Supply01:24

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Rapidly dividing tumors, embryos, and wounded tissues require more oxygen than usual, lowering the oxygen concentration in the blood. At low oxygen or hypoxic conditions, an oxygen-sensitive transcription factor called the hypoxia-inducible factor 1 or HIF1 is activated. HIF1 is a dimeric protein of alpha (ɑ) and beta (β) subunits.  Under optimal oxygen conditions, HIF1β is present in the nucleus while HIF1ɑ remains in the cytosol. HIF1ɑ is hydroxylated by prolyl...
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Molecular Factors Affecting Cell Division01:27

Molecular Factors Affecting Cell Division

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Several external and internal factors influence the initiation and inhibition of cell division. For instance, the death of nearby cells or the release of human growth hormone (hGH) promotes cell division. In contrast, lack of hGH or crowding of cells can inhibit cell division.
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Factors Affecting Erythropoiesis01:24

Factors Affecting Erythropoiesis

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The cardiovascular system regulates the number of erythrocytes in the bloodstream to ensure optimal oxygen transport. It also prevents over-proliferation of these cells, which helps to maintain blood viscosity and flow rate.
Several factors influence the erythrocyte production rate, with tissue oxygen level being among the most critical. Intense exercise or high altitudes can cause tissue hypoxia, which triggers the kidneys to release more erythropoietin (EPO) into the bloodstream.
EPO then...
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In Vivo Osteo-organoid Approach for Harvesting Therapeutic Hematopoietic Stem/Progenitor Cells
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WBC Growth Factors: ASCO Guideline Update.

Bishal Gyawali1, Kari Bohlke2, Jana K Dickter3

  • 1Queen's University, Kingston, ON, Canada.

Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
|February 25, 2026
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Summary
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Hematopoietic colony-stimulating factors (CSFs) are recommended for cancer patients to prevent febrile neutropenia when chemotherapy risk is high. CSFs also aid in stem cell mobilization, with updated guidelines on their use and selection.

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Area of Science:

  • Oncology
  • Hematology
  • Supportive Care

Background:

  • Neutropenic events and febrile neutropenia are significant risks for cancer patients undergoing chemotherapy.
  • Hematopoietic colony-stimulating factors (CSFs) are crucial in managing these risks and in stem cell mobilization.

Purpose of the Study:

  • To provide an updated American Society of Clinical Oncology (ASCO) guideline on the use of CSFs in adult cancer patients.
  • To incorporate new evidence regarding CSFs, biosimilars, and related agents for neutropenia prevention and stem cell mobilization.

Main Methods:

  • A systematic review of randomized controlled trials (RCTs), meta-analyses, and systematic reviews was conducted.
  • Literature search covered PubMed and Cochrane Library for articles published between September 1, 2014, and August 22, 2025.
  • An ASCO Expert Panel reviewed the evidence to formulate updated recommendations.

Main Results:

  • The review included 33 RCTs and 16 systematic reviews.
  • New CSFs, additional biosimilars, and a CXCR4 inhibitor for stem cell mobilization were identified as additions to the evidence base.
  • Evidence supports the use of CSFs for specific risk thresholds of febrile neutropenia and for stem cell mobilization.

Conclusions:

  • Prophylactic CSFs are recommended for chemotherapy with a febrile neutropenia risk of approximately 20% or higher.
  • Primary CSF prophylaxis may be warranted for chemotherapy with <20% risk if patients have high-risk characteristics.
  • CSFs are effective for stem cell mobilization, alone or in combination with CXCR4 inhibitors; updated guidance on dosing and selection is provided.