[Biological properties and clinical application of filgrastim (G-CSF)]

Granulocyte--colony stimulating factor (G-CSF, filgrastim) is a glycoprotein hormone of the hematopoietin family that primarily influences the proliferation and differentiation of neutrophilic granulocytic precursors. As with all glyco-protein hormones, G-CSF interacts with target cells by binding to specific cell-surface receptors. It stimulates proliferation, differentiation and activation of cells of the neutrophil--granulocyte lineage and has been investigated as therapy for patients with various neutropenic conditions. A major use for recombinant G-CSF therapy will be in ameliorating the neutropenia which follows cytoreductive chemotherapy. The increase in neutrophils produced by this factor render it a useful treatment for conditions such as congenital, acquired and cyclic neutropenias. It may be an effective therapy in myelodysplasia and aplastic anaemia. G-CSF is also useful in accelerating the recovery of transplanted bone marrow in patients with leukaemia, lymphoma and solid tumors. G-CSF is well tolerated. The most frequently reported adverse effect is mild to moderate bone pain.