Hematopoiesis and growth factors in elderly cancer patients

Hemopoietic Growth Factors (GF) are glycoprotein hormones that regulate the proliferation and differentiation of hematopoietic progenitor cells and of mature blood cell function. In last years GFs have moved from the laboratory study to the clinical area, and most of them have been produced on a large scale through recombinant DNA technology. Hemopoiesis and GF sensitivity of marrow cells declines with age, impairing the ability of elderly people to increase the production of GFs under stress conditions. In elderly cancer patients chemotherapy-associated neutropenia very frequently causes fever or infection with dose delay and increased morbidity and mortality rate, therefore in this setting beneficial effects of adjunct treatment with GFs have been proposed. Since reduction in neutropenia and in the risk of infection does not necessarily result in improved remission rate and long-term survival, some recommendations on the use (or abuse) of GFs are reviewed in this paper.