Use of hematopoietic growth factors in marrow transplantation.

Results of clinical trials in bone marrow transplantation (BMT) patients have shown that morbidity associated with myelosuppressive chemo- or radiotherapy is reduced in patients receiving hematopoietic growth factors such as recombinant human granulocyte colony-stimulating factor or recombinant human granulocyte-macrophage colony-stimulating factor. Recombinant human granulocyte-macrophage colony-stimulating factor has been approved by the Food and Drug Administration to speed neutrophil recovery, to reduce the severity and duration of infection, and to shorten hospital stays of patients with lymphoid malignancy who undergo autologous BMT. Recombinant human granulocyte colony-stimulating factor is not approved by the Food and Drug Administration as therapy in BMT; however, results of phase I and phase II trials suggest similar beneficial effects in autologous BMT. Both molecules are well tolerated in patients undergoing autologous or allogeneic BMT. Other hematopoietic growth factors, such as recombinant Human macrophage colony-stimulating factor, recombinant human interleukin (rhIL)-3, rhIL-3-GM-CSF (rh-PIXY 321), rhIL-6, rhIL-1, rhc-kit ligand (rh-KL), and erythropoietin (rh-EPO), are also being studied singly or in combination in patients undergoing BMT. The use of hematopoietic growth factors in marrow transplantation is reviewed.