Appelbaum F R
Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA 98104.
Semin Hematol. 1989 Jul;26(3 Suppl 3):7-14.
Recombinant DNA technology has allowed for the production of large quantities of several hematopoietic growth factors as cloned gene products. Three of these factors--recombinant human erythropoietin (r-HuEPO), granulocyte macrophage colony-stimulating factor (GM-CSF), and granulocyte colony-stimulating factor (G-CSF)--are currently undergoing clinical trials and appear to offer considerable promise for the treatment of a variety of hematopoietic abnormalities. Therapy with r-HuEPO can raise the hematocrit levels of patients with end-stage renal disease. Therapy with GM-CSF in patients undergoing marrow transplantation results in acceleration of granulocyte and platelet recovery by 1 to 2 weeks, leading to fewer infections and earlier discharge from the hospital. Other demonstrated uses of GM-CSF include treatment for aplastic anemia, myelodysplastic syndromes, chemotherapy-induced neutropenia, and neutropenia associated with the acquired immunodeficiency syndrome (AIDS). Similar beneficial effects have been reported with G-CSF. Other hematopoietic growth factors, including the interleukins (IL)-1, -3, and -6, will soon be entering clinical trials. For the first time, the availability of a large number of hematopoietic growth factors may allow physicians to regulate closely the entire hematopoietic system of their patients.
重组DNA技术已能够大量生产几种造血生长因子作为克隆基因产物。其中三种因子——重组人促红细胞生成素（r-HuEPO）、粒细胞巨噬细胞集落刺激因子（GM-CSF）和粒细胞集落刺激因子（G-CSF）——目前正在进行临床试验，并且似乎为治疗各种造血异常带来了很大希望。用r-HuEPO进行治疗可以提高终末期肾病患者的血细胞比容水平。对接受骨髓移植的患者使用GM-CSF进行治疗可使粒细胞和血小板的恢复加快1至2周，从而减少感染并使患者更早出院。GM-CSF的其他已证实用途包括治疗再生障碍性贫血、骨髓增生异常综合征、化疗引起的中性粒细胞减少症以及与获得性免疫缺陷综合征（AIDS）相关的中性粒细胞减少症。据报道，G-CSF也有类似的有益效果。其他造血生长因子，包括白细胞介素（IL）-1、-3和-6，很快也将进入临床试验。首次有大量造血生长因子可供使用，这可能使医生能够密切调节患者的整个造血系统。
