-
Views
-
Cite
Cite
William P. Peters, Medical and economic implications of hematopoietic colony-stimulating factor use in oncology, The International Journal Of Cell Cloning, Volume 9, Issue S1, 1991, Pages 31–39, https://doi.org/10.1002/stem.5530090707
Close - Share Icon Share
Abstract
There is increasing experimental and clinical evidence for a dose-response effect in the treatment of solid tumors. For most chemotherapy programs, myelosuppression is the toxicity which limits dose escalation. The use of autologous bone marrow permits further dose escalation limited by toxicity to normal organs. The use of hematopoietic colony-stimulating factors (CSFs) has shortened the period of myelosuppression, although with the use of granulocyte-macrophage (GM) CSF or granulocyte (G) CSF alone there reMayns an extended period of absolute leukopenia during which many of the complications associated with high-dose therapy occur. The apparent lack of effect of GM-CSF and G-CSF during the early days after bone marrow infusion appears to result from a deficiency of progenitors capable of responding to these factors until the infused marrow has sufficient time to proliferate and differentiate sufficiently to be able to respond to these CSFs. More recently, the use of CSF-primed peripheral blood progenitor cells has permitted a marked reduction in the period of absolute leukopenia associated with autologous bone marrow transplantation and, as well, produced a reduction in the number of hospital days, in platelet and red cell transfusions, and in the need for antibiotics. Toxicity of the treatment program is substantially reduced. Finally, this has had a profound impact on the hospital charges associated with transplantation. Future directions may include the use of interleukin (IL) 3 or IL-1 as a way to further decrease the myelosuppression associated with transplantation.
