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Pharmacodynamic Effects of Haematopoietic Cytokines: The View of a Clinical Oncologist.
- Source :
-
Basic & Clinical Pharmacology & Toxicology . Mar2010, Vol. 106 Issue 3, p210-214. 5p. - Publication Year :
- 2010
-
Abstract
- The production of haematopoietic cells is under the tight control of a group of haematopoietic cytokines. Each cytokine has multiple actions mediated by receptors whose cytoplasmic domains contain specialized regions initiating survival, proliferation, differentiation commitment, maturation and functional activation. Granulocyte colony-stimulating factor (G-CSF), erythropoietin (EPO), and thrombopoiesis-stimulating agents are in routine clinical use to stimulate cell production and in total have been used in the management of many millions of patients. G-CSF regulates neutrophil production to maintain blood neutrophil counts in the normal range. G-CSF is used to prevent febrile neutropenia or to increase dose-density in chemotherapy regimens. Despite consistently showing a shorter duration of neutropenia, multiple prospective randomized trials have documented only modest clinical benefit. A clinical advantage of dose-dense chemotherapy has been shown only in specific chemotherapy regimens. Professional recommendations tailor the use of CSFs to patients with a high risk of adverse outcome of febrile neutropenia. EPO was used to prevent anaemia requiring red blood cell transfusion. However, recent studies strongly suggest a negative overall effect on mortality, without a plausible biological explanation. It is now proposed that its use should be restricted to patients in clinical trials. Thrombopoiesis-stimulating agents have only been recently introduced into the market for splenectomized and non-splenectomized patients with immune thrombocytopenic purpura, a rare disease. Before widely used in other conditions such as chemotherapy-induced thrombocytopenia, the lessons learned from the example of G-CSF and EPO should be taken seriously. [ABSTRACT FROM AUTHOR]
- Subjects :
- *ONCOLOGISTS
*CYTOKINES
*ERYTHROPOIETIN
*PATIENTS
*CLINICAL trials
Subjects
Details
- Language :
- English
- ISSN :
- 17427835
- Volume :
- 106
- Issue :
- 3
- Database :
- Academic Search Index
- Journal :
- Basic & Clinical Pharmacology & Toxicology
- Publication Type :
- Academic Journal
- Accession number :
- 48034611
- Full Text :
- https://doi.org/10.1111/j.1742-7843.2009.00514.x