The Role of Myeloid Growth Factors in Acute Leukemia

Authors:
Martha WadleighDana-Farber Cancer Institute, Boston, Massachusetts

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Richard M. StoneDana-Farber Cancer Institute, Boston, Massachusetts

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Volume/Issue:
Volume 7: Issue 1
Online Publication Date:
Jan 2009
DOI:
https://doi.org/10.6004/jnccn.2009.0007
Full access

Myeloid growth factors granulocyte-colony stimulating and granulocyte macrophage colony-stimulating factors have been extensively studied in acute leukemias. Whether administered before, during, or after chemotherapy for acute myeloid leukemia and acute lymphoblastic leukemia, these agents reduce the duration of neutropenia and seem to be safe and well tolerated. Despite consistently showing a shorter duration of neutropenia, multiple, prospective, randomized trials have documented only modest benefits in terms of reduction in the incidence and severity of infections, without substantial gains or impact in complete remission, overall survival, and disease-free survival rates. Growth factors have also been used to recruit quiescent leukemia cells into the S-phase of the cell cycle to increase their susceptibility to chemotherapy with the goal to reduce relapse and resistance. Randomized trials evaluating this priming strategy have consistently shown improvement in disease- or event-free survival in the intermediate-risk group of patients with acute myeloid leukemia, but no overall survival benefit. This article focuses on the clinical experience with these agents as adjuncts to the treatment of acute leukemias.

Correspondence: Martha Wadleigh, MD, Dana-Farber Cancer Institute, 44 Binney Street, Boston, MA 02115.E-mail: Martha_Wadleigh@DFCI.Harvard.edu
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Copyright:
Copyright © 2009 by the National Comprehensive Cancer Network 2009
Page Numbers:
8
Article Category:
Research Article
Received:
14 Aug 2008
Accepted:
12 Nov 2008
Print Publication Date:
01 Jan 2009
Online Publication Date:
Jan 2009
Keywords:
Myeloid growth factors; acute myeloid leukemia; acute lymphoblastic leukemia; priming
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