![]() |
![]() |
![]() |
Chapter 3
Hematopoietic growth factors
Introduction
Hematopoiesis, the orderly production of mature circulating blood cells from stem cells residing in the marrow, is described in Chapter 2. A host of hematopoietic growth factors and their receptors play essential roles in hematopoiesis. This chapter will focus on the hematopoietic growth factors that are in clinical use. Certain of these cytokines have been modified to alter their pharmacokinetic profile in vivo; these will also be discussed. Phage display techniques or high throughput screening programs have identified a number of novel small peptides or nonpeptide molecules that can bind to a hematopoietic growth factor receptor and mimic the
Erythropoietin (epoetin alfa)
Chronic renal failure Anemia in preterm infants Anemia associated with human immunodeficiency virus infection Anemia in patients with cancer receiving chemotherapy or radiation therapy Reduction in allogeneic transfusion in surgery patients Other uses of epoetin alfa
Darbepoetin alfa
Chronic renal failure Anemia in patients with cancer receiving chemotherapy Other uses of darbepoetin alfa
Thrombopoietin
Chemotherapy-induced thrombocytopenia Other potential uses Side effects
Interleukin-11 (oprelvekin)
Primary prevention of chemotherapy-induced thrombocytopenia Secondary prevention of chemotherapy-induced thrombocytopenia Potential uses Side effects
Stem cell factor (ancestim)
Mobilization of peripheral blood stem cells Side effects
Granulocyte-macrophage colony-stimulating factor (sargramostim, molgramostim)
Granulocyte colony-stimulating factor (filgrastim, lenograstim)
Clinical use of sargramostim and filgrastim Acute myelogenous leukemia Mobilize autologous peripheral blood stem cells and enhance neutrophil recovery after transplantation Mobilize peripheral blood stem cells from normal donors for allogeneic transplantation Accelerate neutrophil recovery after bone marrow transplantation Improve neutrophil production in patients with delayed engraftment or graft failure after bone marrow transplantation Accelerate neutrophil recovery following myelosuppressive chemotherapy Febrile neutropenia Severe chronic neutropenia (idiopathic, cyclic, congenital) Myelodysplasia Potential clinical uses of sargramostim Potential clinical uses of filgrastim Side effects of sargramostim or filgrastim
Pegylated methionyl G-CSF (pegfilgrastim)
| |||||||||||||||||||||||||||||||||||||||||||||||||||