Hematopoietic growth factors in the pathogenesis and for the treatment of aplastic anemia

被引:27
作者
Marsh, JCW [1 ]
机构
[1] Univ London St Georges Hosp, Sch Med, Dept Haematol, London SW17 0RE, England
关键词
D O I
10.1016/S0037-1963(00)90032-5
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The production and release of hematopoietic growth factors from bone marrow stromas established in vitro from patients with aplastic anemia is normal or increased. Addition of hematopoietic growth factors to aplastic anemia bone marrow cells results in only modest increases in colony growth, with the exception of granulocyte colony-stimulating factor (G-CSF), which corrects their impaired cloning efficiency to normal. Most clinical data on the use of hematopoietic growth factors in aplastic anemia have derived from uncontrolled and small single-arm studies or case reports. Sustained trilineage hematologic responses have not been observed when hematopoietic growth factors have been used alone or in combination. Serious side effects have been reported for most of the hematopoietic growth factors in patients with aplastic anemia, with the exception of G-CSF. There is a major concern that they may further increase the risk of clonal disorders such as myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). Hematopoietic growth factors should not be used alone in newly diagnosed patients as specific treatment for aplastic anemia, and their use In combination with immunosuppressive therapy should be confined to multicenter, prospective randomized studies. Copyright (C) 2000 by W.B. Saunders Company.
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页码:81 / 90
页数:10
相关论文
共 87 条
[21]  
GIBSON FM, 1994, EXP HEMATOL, V22, P302
[22]  
Gluckman E, 1998, BLOOD, V92, p376A
[23]  
GLUCKMAN E, 1992, BLOOD, V79, P2540
[24]  
GUINAN EC, 1990, BLOOD, V76, P1077
[25]   Concentrations of thrombopoietin in bone marrow in normal subjects and in patients with idiopathic thrombocytopenic purpura, aplastic anemia, and essential thrombocythemia correlate with its mRNA expression of bone marrow stromal cells [J].
Hirayama, Y ;
Sakamaki, S ;
Matsunaga, T ;
Kuga, T ;
Kuroda, H ;
Kusakabe, T ;
Sasaki, K ;
Fujikawa, K ;
Kato, J ;
Kogawa, K ;
Koyama, R ;
Niitsu, Y .
BLOOD, 1998, 92 (01) :46-52
[26]   CYTOKINE MESSENGER-RNA EXPRESSION OF BONE-MARROW STROMAL CELLS FROM PATIENTS WITH APLASTIC-ANEMIA AND MYELODYSPLASTIC SYNDROME [J].
HIRAYAMA, Y ;
KOHGO, Y ;
MATSUNAGA, T ;
OHI, S ;
SAKAMAKI, S ;
NIITSU, Y .
BRITISH JOURNAL OF HAEMATOLOGY, 1993, 85 (04) :676-683
[27]   APLASTIC-ANEMIA - ANALYSIS OF STROMAL CELL-FUNCTION IN LONG-TERM MARROW CULTURES [J].
HOLMBERG, LA ;
SEIDEL, K ;
LEISENRING, W ;
TOROKSTORB, B .
BLOOD, 1994, 84 (11) :3685-3690
[28]   MYELODYSPLASIA AND ACUTE MYELOID-LEUKEMIA IN CASES OF APLASTIC-ANEMIA AND CONGENITAL NEUTROPENIA FOLLOWING G-CSF ADMINISTRATION [J].
IMASHUKU, S ;
HIBI, S ;
KATAOKAMORIMOTO, Y ;
YOSHIHARA, T ;
IKUSHIMA, S ;
MORIOKA, Y ;
TODO, S .
BRITISH JOURNAL OF HAEMATOLOGY, 1995, 89 (01) :188-190
[29]   Long-term administration of G-CSF for aplastic anaemia is closely related to the early evolution of monosomy 7 MDS in adults [J].
Kaito, K ;
Kobayashi, M ;
Katayama, T ;
Masuoka, H ;
Shimada, T ;
Nishiwaki, K ;
Sekita, T ;
Otsubo, H ;
Ogasawara, Y ;
Hosoya, T .
BRITISH JOURNAL OF HAEMATOLOGY, 1998, 103 (02) :297-303
[30]  
KOJIMA S, 1991, BLOOD, V77, P937