Current status of clinical indications for hematopoietic growth factors after chemo-/radiotherapy in gynecology
Karthaus, M.; Ganser, A.
Zentralblatt für Gynakologie 119(12): 585-596
1997
ISSN/ISBN: 0044-4197 PMID: 9483809 Document Number: 474177
With the identification and recombinant production of the hematopoietic growth factors, these cytokines have been evaluated in the treatment of primary bone marrow failure states and following myelosuppressive chemotherapy or radiotherapy. An increasing number of clinical trials with hematopoietic factors have been performed in patients with haematological and oncological diseases. Granulocyte colony-stimulating factor (G-CSF), granulocyte-macrophage colony-stimulating factor (GM-CSF), erythropoietin and, in phase I/II trials, thrombopoietin (TPO) are available for the clinical use. Most studies have been performed with G-CSF and GM-CSF, their beneficial effects are proven regarding acceleration of hematopoietic recovery following chemotherapy. This results in a marked reduction of infectious risks and a shortening of drug- and radiation-induced myelosuppression. CSFs are most important in mobilizing peripheral blood progenitor cells (PBPC) and have allowed high-dose therapy combined with stem cell support in gynecological malignancies, e.g. ovarian carcinoma and breast cancer. However, evidence based, clinical practical guidelines for the use of hematopoietic growth factors in gynecological malignancies are not for all circumstances available.