Fox R M
Department of Clinical Haematology and Medical Oncology, Royal Melbourne Hospital, Melbourne, Australia.
Pharmacoeconomics. 1994;6 Suppl 2:1-8. doi: 10.2165/00019053-199400062-00003.
Granulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor (GM-CSF) have been used successfully to enhance neutrophil recovery in patients with various malignancies undergoing standard or high dose chemotherapy, with or without autologous or allogeneic bone marrow transplantation support, and offer potential advantages in these settings in terms of reducing the total costs of healthcare and/or improving therapeutic outcomes. Clinical trials are now aimed at identifying which patients and which nonhaematological malignancies will respond best to colony-stimulating factor (CSF) support, and which of the 2 factors is the most appropriate in each setting. Two areas of considerable interest at present are the potential for chemotherapy dose optimisation and intensification with CSF therapy, and the use of CSFs to permit the harvest and reinfusion of peripheral blood progenitor cells as an alternative to autologous or allogeneic bone marrow transplantation. In the case of dose-intensified chemotherapy, costs of treatment increase but the gain may be an increase in survival rates or disease-free intervals. The potential of G-CSF and GM-CSF therapy in other conditions, notably haematological malignancies such as myelodysplasia and myeloid leukaemias, and AIDS, means that these agents are likely to make a significant impact on the treatment of a wide range of debilitating conditions in the future.
粒细胞集落刺激因子（G-CSF）和粒细胞巨噬细胞集落刺激因子（GM-CSF）已成功用于提高接受标准或高剂量化疗的各种恶性肿瘤患者的中性粒细胞恢复，无论有无自体或异基因骨髓移植支持，并且在这些情况下在降低医疗保健总成本和/或改善治疗结果方面具有潜在优势。目前的临床试验旨在确定哪些患者和哪些非血液系统恶性肿瘤对集落刺激因子（CSF）支持反应最佳，以及在每种情况下这两种因子中哪一种最合适。目前两个备受关注的领域是CSF治疗优化和强化化疗剂量的潜力，以及使用CSF允许采集和回输外周血祖细胞作为自体或异基因骨髓移植的替代方法。在剂量强化化疗的情况下，治疗成本会增加，但收益可能是生存率或无病间期的提高。G-CSF和GM-CSF治疗在其他疾病中的潜力，特别是血液系统恶性肿瘤如骨髓增生异常综合征和髓系白血病以及艾滋病，意味着这些药物未来可能会对广泛的衰弱性疾病的治疗产生重大影响。
