The Role of GM-CSF, G-CSF, Interleukin-3, and Erythropoietin in Myelodysplastic Syndromes

Abstract

Hematopoietic growth factors are being used in patients with myelodysplastic syndromes with increasing frequency to reverse pancytopenia. Treatment with granulocyte-macrophage colony stimulating factor (GM-CSF) and granulocyte colony stimulating factor (G-CSF) has resulted in an increase in segmented neutrophil counts and a reduction in the infection rate, whereas a stimulatory effect on platelet count and hematocrit was uncommon. Progression to acute leukemia has been observed, but could have been due to the natural course of the disease. Combination therapy with GM-CSF and low-dose cytosine-arabinoside is being studied in clinical trials. Early results with interleukin-3 have demonstrated a stimulatory effect on neutrophil counts as well as on platelet counts. High doses of erythropoietin have only been successful in 10% of treated patients to improve erythropoiesis.