Treatment of myelodysplastic syndromes with recombinant human granulocyte colony-stimulating factor

Article Abstract:

Myelodysplastic syndromes include disorders that affect the number and functioning of the blood cells produced in the bone marrow. The diseases characteristically involve two or more types of blood cells lines, usually platelets (cells involved in clotting), erythrocytes (red blood cells) and leukocytes (white blood cells). In older patients treatment is limited to replacement of depleted or defective blood cell lines with transfusions and antibiotic therapy to reduce frequent infections. Bone marrow transplantation may be useful in younger patients. Recently, granulocyte colony-stimulating factor (G-CSF), a substance produced by the body that enhances blood cell growth, can be produced in the laboratory in large quantities. The effects of injections with G-CSF were studied in 12 patients with myelodysplastic syndromes. The dose of G-CSF was increased every two weeks for a total of eight weeks. At the end of the treatment period, the leukocyte count increased 2- to 10-fold and neutrophils (a type of white blood cell) increased by 5- to 40-fold. Neutrophils were increased in three out of the five patients with extremely low neutrophil counts. G-CSF helped reduce the number of transfusions required in two out of nine patients with reduced reticulocytes (immature red blood cells). G-CSF increased neutrophils in five patients and reduced the number of transfusions required in two out of nine patients with transfusion-dependent anemia (decreased red blood cells). G-CSF did not alter the amount of platelets, eosinophils, lymphocytes or monocytes. The treatment was well tolerated and did not augment the progression of leukemia, a potential complication of stimulating the growth of blood cell lines. (Consumer Summary produced by Reliance Medical Information, Inc.)

Bone diseases, Myelodysplastic syndromes

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The effect of recombinant human granulocyte-macrophage colony-stimulating factor on neutropenia and related morbidity in chronic severe neutropenia

Article Abstract:

Neutrophils are specialized granular white blood cells, or leukocytes, involved in removing foreign substances from the body. Neutropenia, the abnormal decrease in neutrophils, can be caused by a disease or an infection. Patients who have neutropenia over a long period of time are more prone to infections, particularly upper respiratory infections. Antibiotic therapy can be given to treat these infections. However, elective surgery is risky in these patients and is generally avoided. Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a substance produced by the body that increases the production of blood cells. Human GM-CSF can be produced in the laboratory in large quantities. Laboratory-produced human GM-CSF was administered to four patients with chronic neutropenia, two of whom had life-threatening infections. There was a rapid increase in neutrophil production in all four patients. In addition to improving the outcome of the two patients with severe infection, the other two patients were able to have elective surgery and did not develop postoperative infection. (Consumer Summary produced by Reliance Medical Information, Inc.)

Hematopoiesis

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Hematopoietic growth factors - not whether, but when and where

Article Abstract:

Physicians need to determine which patients will benefit from granulocyte colony-stimulating factor (G-CSF) and which patients will not. G-CSF stimulates the production of blood cells and is often used to boost blood cell production in patients with low blood cell counts. Two 1997 studies found that although G-CSF raised blood cell counts in chemotherapy patients, the overall benefit was very small. However, G-CSF has been shown to benefit patients receiving a stem cell transplant. G-CSF may be most effective if limited to those patients most likely to benefit.

Editorial, Cancer patients

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