THE POTENTIAL ROLE OF CYTOKINE THERAPY FOR FUNGAL-INFECTIONS IN PATIENTS WITH CANCER - IS RECOVERY FROM NEUTROPENIA ALL THAT IS NEEDED

Optimal regimens for the treatment of invasive fungal infections have yet to be defined, and these life-threatening conditions are one of th e leading causes of treatment failure in patients with cancer. A subst antial body of preclinical work points in the direction of using cytok ines as immunomodulators of the multiple deficiencies involved in the progression of fungal infections in neutropenic and nonneutropenic can cer patients. These deficiencies include not only the easily recognize d deficiencies in cell quantity but also subtle deficiencies of cell f unction. Four cytokines (granulocyte colony-stimulating factor, granul ocyte-macrophage colony-stimulating factor, macrophage colony stimulat ing factor, and interferon gamma) show promise as adjuvant therapy for proven fungal infections in this setting, although clinical experienc e is still limited. As an additional approach, the concept of white bl ood cell transfusions has been revived by the use of granulocyte colon y-stimulating factor and promises to be helpful in the setting of neut ropenia.