[Hematopoietic growth factors in practice: importance and problems]

Area of Science:

• Hematology
• Oncology
• Pharmacology

Background:

• Recombinant human hematopoietic cytokines, including granulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage factor (Gm-CSF), represent novel supportive care agents.
• These cytokines are crucial for patients undergoing myelosuppressive chemotherapy and bone marrow transplantation.

Purpose of the Study:

• To evaluate the efficacy of G-CSF and Gm-CSF in reducing neutropenia and improving patient outcomes.
• To assess the role of hematopoietic growth factors in accelerating hematologic recovery after bone marrow grafting.
• To explore the potential of these agents in novel therapeutic approaches and stem cell mobilization.

Main Methods:

• Randomized placebo-controlled studies were conducted to assess the effects of G-CSF and Gm-CSF.
• Studies involved patients undergoing aggressive chemotherapy (ACVB) and bone marrow transplantation (autograft and allograft).
• Data collection focused on duration of neutropenia, infection, hospitalization, and hematologic recovery times.

Main Results:

• Glycosylated G-CSF reduced neutropenia duration from 4 to 1 day in lymphoma patients, decreasing infection and hospital stay.
• G-CSF treatment in bone marrow grafting accelerated neutrophil recovery (16 vs. 27 days) and reduced infection and hospitalization.
• No significant difference in one-year survival was observed between cytokine-treated and control groups in randomized studies.

Conclusions:

• Hematopoietic growth factors significantly diminish chemotherapy and transplantation-related toxicity.
• Further research is needed to identify optimal clinical situations for cytokine use and explore novel applications.
• Hematopoietic factors enhance peripheral blood stem cell mobilization, facilitating integration into dose-intensive treatment regimens.