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Thrombopoietic factors in chronic bone marrow failure states: the platelet problem revisited.

Abstract
Thrombocytopenia is a serious clinical problem in several different clinical settings. In chronic bone marrow failure states, which include aplastic anemia, myelodysplastic syndrome, and graft failure, the prolonged nature of thrombocytopenia often leads to alloimunization after repeated platelet transfusions, the consequence of which is a platelet-refractory state and enhanced risk of bleeding. Despite the introduction of several thrombopoietic factors into clinical trials, an effective way to alleviate thrombocytopenia has been elusive, and the problem in chronic bone marrow failure states has remained poorly addressed by clinical investigations. Even so, several studies by our group and others suggest that a subset of patients suffering from chronic bone marrow failure can respond to appropriate growth factor therapy. The temporal pace of response appears, however, to be much slower than that observed after administering growth factors which act on neutrophils. On the other hand, durable responses can be secured in some patients given thrombopoietic factors for long periods of time. Herein, we provide an overview of the clinical research investigations of thrombopoietic factors in chronic bone marrow failure, and the emerging insights these studies provide for understanding the process of thrombopoiesis and its therapy in this setting.
AuthorsRazelle Kurzrock
JournalClinical cancer research : an official journal of the American Association for Cancer Research (Clin Cancer Res) Vol. 11 Issue 4 Pg. 1361-7 (Feb 15 2005) ISSN: 1078-0432 [Print] United States
PMID15746033 (Publication Type: Journal Article, Review)
Chemical References
  • Interleukin-11
  • Interleukin-3
  • Interleukin-6
  • Stem Cell Factor
  • Thrombopoietin
Topics
  • Anemia, Aplastic (complications)
  • Bone Marrow Diseases (complications)
  • Chronic Disease
  • Interleukin-11 (therapeutic use)
  • Interleukin-3 (therapeutic use)
  • Interleukin-6 (therapeutic use)
  • Myelodysplastic Syndromes (complications)
  • Platelet Transfusion
  • Stem Cell Factor (therapeutic use)
  • Thrombocytopenia (complications, therapy)
  • Thrombopoiesis (drug effects)
  • Thrombopoietin (therapeutic use)

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