Transfusion support of hematology and oncology patients. The role of recombinant hematopoietic growth factors.

Recombinant DNA technology has made more than a dozen human cytokines available to treat patients with hematologic and oncologic disorders. These small glycoproteins mediate cell growth and differentiation and regulate complex cellular networks by autocrine, paracrine, and endocrine mechanisms. Direct infusions of hematopoietic cytokines can decrease the requirement for transfusion in many patients with hematologic disorders and malignancies and permit more aggressive myelosuppressive therapy. Stimulation of blood donors with cytokines may enhance collection of a variety of transfusion components from granulocytes to peripheral blood progenitor cells. Using combinations of recombinant growth factors can effect ex vivo cell expansion and differentiation. Such cellular components are currently being studied in immunotherapy of cancer, in molecular approaches to inherited and acquired genetic abnormalities, and in bone marrow transplantation. In the future, this technology may be applied to producing transfusion components.