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Use of cytokines during prolonged neutropenia associated with autologous bone marrow transplantation.

Molecular cloning, expression, and formulation of recombinant myeloid colony-stimulating factors (CSFs) have afforded the potential to reduce therapy-associated toxicity in patients who receive intensive chemotherapy. The use of granulocyte CSF and granulocyte-macrophage CSF has resulted in acceleration of hematopoietic recovery in patients undergoing autologous bone marrow transplantation. This acceleration is associated with a reduction of treatment-related toxicity, although a period of absolute leukopenia prevails despite infusion of bone marrow and recombinant CSFs. Addition of CSF-primed peripheral blood progenitor cells to bone marrow in the supportive care of these patients has provided a further reduction in the duration of absolute leukopenia and an associated reduction in the incidence of infections and other complications associated with bone marrow transplantation. The ability of CSFs to mobilize hematopoietic progenitor cells offers the possibility of utilizing these cells for a variety of medical purposes, including modification of the therapeutic approach to malignant disease.