Colony stimulating factors (CSF) for white blood cells are formed in the bone-marrow and regulate proliferation and differentiation of the myeloid cells. Several of these
hormones are cloned and manufactured by a recombinant technique for clinical use. The
granulocyte-macrophage-colony-stimulating factor (
GM-CSF) and the
granulocyte-colony-stimulating factor (
G-CSF) both belong to this group. Trials are still at the commencing stage. In vitro investigations, animal experiments and human experiments have rendered promising results. After intensive
chemotherapy followed by treatment with
GM-CSF and
G-CSF, it has been demonstrated that the period of
neutropenia following bone-marrow suppression is abbreviated. Accelerated bone-marrow regeneration and reduced tendencies to
infection have been demonstrated compared with so-called control patients. In patients with the
myelodysplastic syndrome, marked increase in the neutrophile granulocytes in the peripheral blood has been observed during treatment with
growth factors. Long-term treatment with
G-CSF has proved particularly effective in chronic idiopathic and
cyclic neutropenia. On the other hand, the
growth factors can scarcely improve the prognosis in severe
aplastic anaemia. Animal experiments and a single human trial suggest that
G-CSF and
GM-CSF treatment are indicated in bone-marrow insufficiency secondary to radioactive irradiation accidents.
GM-CSF has normalized the leucocyte counts in
AIDS patients with leucopenia without any marked alteration in the tendency to
infection. Future studies will show whether simultaneous treatment with
growth factors and anti-viral and anti-leukaemic treatments, respectively, can improve the therapeutic results.