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Chapter 3
Hematopoietic growth factors
The hematopoietic growth factors (HGFs) and their receptors play essential roles in regulating hematopoiesis (see Chapter 2). For each hematopoietic lineage, specific factors are critical for producing and maintaining circulating levels of the cells. For example, granulocyte colony-stimulating factor regulates neutrophil production; granulocyte- macrophage colony-stimulating factor enhances production of neutrophils, monocytes, and eosinophils; erythropoietin regulates red blood cell production; and thrombopoietin regulates platelet production. This chapter focuses on results of clinical trials and approved uses for these HGFs and provides an overview of other factors at early stages in development.
Myeloid growth factors
Granulocyte colony-stimulating factor (filgrastim, lenograstim)
Granulocyte colony-stimulating factor (G-CSF) is a myeloid growth factor produced Pegylated methionyl G-CSF (pegfilgrastim) Granulocyte-macrophage colony-stimulating factor (sargramostim, molgramostim) Clinical use of G-CSF and GM-CSF Prevention of chemotherapy-induced febrile neutropenia Pegfilgrastim for prevention of febrile neutropenia GM-CSF for prevention of febrile neutropenia Clinical guidelines for the use of the myeloid growth factors Febrile neutropenia Acute myelogenous leukemia Acute lymphoblastic leukemia Mobilization of autologous peripheral blood stem cells and enhancement of neutrophil recovery after transplantation Mobilization of peripheral blood stem cells from normal donors for allogeneic transplantation Acceleration of neutrophil recovery after bone marrow transplantation Improvement of neutrophil production in patients with delayed engraftment or graft failure after bone marrow transplantation Severe chronic neutropenia (idiopathic, cyclic, congenital) Myelodysplasia Other potential clinical uses of G-CSF Human immunodeficiency virus Leukapheresis Diabetes Pneumonia Myocardial infarction Adverse effects of G-CSF Adverse effects of GM-CSF Risk of leukemia with G-CSF and GM-CSF New versions of G-CSF and GM-CSF
Erythroid growth factors
Erythropoietin (epoetin alfa) Chronic renal failure Anemia in preterm infants Anemia associated with HIV infection Anemia in patients with cancer receiving chemotherapy or radiation therapy FDA regulations ASCO/American Society of Hematology guideline recommendations for erythropoietin Other uses of epoetin alfa Adverse effects associated with the use of erythropoietin Darbepoetin alfa Darbepoetin alfa for chronic renal failure Darbepoetin alfa for anemia associated with chemotherapy Other uses of darbepoetin alfa Adverse effects associated with the use of darbepoetin alfa
Platelet growth factors
Thrombopoietin Chemotherapy-induced thrombocytopenia Interleukin-11 (oprelvekin) Primary prevention of chemotherapy-induced thrombocytopenia Secondary prevention of chemotherapy-induced thrombocytopenia Adverse effects of oprelvekin
Other HGFs
Stem cell factor (ancestim) Mobilization of peripheral blood stem cells Adverse effects of ancestim | ||||||||||||||||||||||||||||||||||||||||||||||||||