Ganser A, Karthaus M
Department of Hematology and Oncology, Hannover Medical School, Germany.
Curr Opin Oncol. 1996 Jul;8(4):265-9. doi: 10.1097/00001622-199607000-00001.
With the identification of recombinant production of the hematopoietic growth factors, these cytokines have been evaluated in the treatment of primary bone marrow failure states and after myelosuppressive chemo- or radiotherapy. Granulocyte colony-stimulating factor, granulocyte-macrophage colony-stimulating factor, and erythropoietin have been approved for clinical use, and others including c-mpl-ligand (also called megakaryocyte growth and development factor or thrombopoietin) are in phase I and II trials. Most studies have been done with granulocyte and granulocyte-macrophage colony-stimulating factors; their beneficial effects are proven regarding acceleration of granulocyte recovery after chemo- and radiotherapy. In the majority of trials, this acceleration results in a reduction of infectious risks, a shortening of drug- and radiation-induced myelosuppression, and a higher chemotherapy dose intensity; however, an improved remission rate and improved long-term survival rates have not yet been definitively documented. Guidelines have been published to provide a rational basis for the use of these factors in clinical practice. It should be emphasized, however, that for many of the recommendations data from randomized clinical trials are lacking.
随着造血生长因子重组生产的确定，这些细胞因子已在原发性骨髓衰竭状态以及骨髓抑制性化疗或放疗后进行了评估。粒细胞集落刺激因子、粒细胞-巨噬细胞集落刺激因子和促红细胞生成素已被批准用于临床，其他包括c-mpl配体（也称为巨核细胞生长和发育因子或血小板生成素）正处于I期和II期试验中。大多数研究是针对粒细胞和粒细胞-巨噬细胞集落刺激因子进行的；它们在化疗和放疗后加速粒细胞恢复方面的有益作用已得到证实。在大多数试验中，这种加速导致感染风险降低、药物和辐射诱导的骨髓抑制缩短以及化疗剂量强度提高；然而，缓解率提高和长期生存率提高尚未得到确切证实。已发布指南为这些因子在临床实践中的使用提供合理依据。然而，应该强调的是，许多建议缺乏来自随机临床试验的数据。
