The colony stimulating factors for the management of chemotherapy-induced neutropenia

Neutropenia is without any doubts the most severe and risky side effect of chemioterapy. In the 60-s of the 20 th century the colony stimulating factors (CSFs) were discovered. The principal use of the CSFs in cancer treatment is to accelerate marrow recovery after chemotherapy, thus shortening the duration of severe neutropenia and reducing the risk of bacterial and fungal infections. The strongest evidence for the use of CSFs in cancer treatment is for prevention of febrile neutropenia after myelotoxic chemotherapy. At the beginning of anticancer chemioterapy the the doses were applied to let marrow recovery after each course of treatment. With the development of the hematopoietic growth factors, however, it became possible to compress treatment schedules and give standard doses of chemotherapy agents on an accelerated schedule, i.e., at less than three-week intervals. The use of the colony stimulating factors to prevent chemotherapy-induced neutropenia is based upon the physiological understanding of the regulation of neutrophil production and deployment in the body under normal conditions and in response to infections. The availability of the CSFs has greatly improved our treatment of patients with cancer. It is possible that innovations in the use of these agents will lead to further improvements in cancer treatment soon.