THE CLINICAL UTILITY OF GRANULOCYTE-COLONY-STIMULATING FACTOR - EARLYACHIEVEMENTS AND FUTURE PROMISE

Recombinant granulocyte colony-stimulating factor (rHuG-CSF) is a hema topoietic growth factor that acts selectively on the neutrophil lineag e, and has had a major impact on clinical practice. Two forms are in c linical use: filgrastim has been approved for use in more than 45 coun tries for the amelioration of chemotherapy-induced neutropenia and res toration of granulopoiesis following bone-marrow transplantation and l enograstim has been approved in Europe and Japan. In some countries, r HuG-CSP is also approved for various other indications, such as severe chronic neutropenia. Infection and neutropenia are a major cause of m orbidity and mortality following cytotoxic chemotherapy, and there is a known correlation between neutropenia and the risk of infection. Hem atopoietic growth factors have been used successfully in the preventio n and treatment of neutropenia. There is evidence to suggest that use of rHuG-CSF before the onset of neutropenia allows patients to receive the maximum benefit; however, patients who do not receive rHuG-CSF pr ophylactically still benefit from the use of rHuG-CSF for the treatmen t of febrile neutropenia. These patients have an accelerated neutrophi l recovery and a shorter duration of febrile neutropenia. These effect s seem to translate into a significant reduction in the number of pati ents requiring prolonged hospitalization. This paper reviews the use o f rHuG-CSF in the treatment of febrile neutropenia and describes how i t is routinely used by hematologists and oncologists in non-clinical t rial settings.