HEMATOPOIETIC GROWTH FACTORS
Hematopoietic growth factors are glycoproteins, which play a major role in the proliferation, differentiation and survival of primitive hematopoietic stem and progenitor cells, as well in functional activation of some mature cells.
These growth factors include erythropoietin (for RBCs), colony stimulating factors (G-CSF, GM-CSF and M-CSF and SCF) and interleukins IL1-16 (for leukocytes) and thrombopoietin (for platelets).Erythropoietin, an erythropoiesis stimulant, is produced by kidney and currently available as recombinant preparation for clinical use (SC 50-150 U/kg/alternate day). It is primary used in cases with decreased bone marrow activity despite presence of stem cells, e.g. (a) chronic renal disease, (b) apnea of prematurity, (c) anemia during cancer chemotherapy, (d) myelodysplastic disorders and (e) to stimulate HbF production in sickle cell anemia.
Graulocyte stimulating factors specially GM-CSF and G-CSF are also available in recombinant form for use in neutropenic cases (SC 5-10 mg/kg or 250 mg/m2), like-(a) malignancy and chemotherapy, (b) aplastic anemia and (c) autologous bone marrow transplantation. However, side effects, e.g. bone pains and rashes are common.
Thrombopoietin: Thrombopoietin is a glycoprotein hormone produced in the liver and kidney which regulate the production of platelets. It stimulates the production and differentiation of megakaryocytes, the bone marrow cells that bud off large number of platelets. Two TPO-RAs, Eltrombopag and Romiplostim have been approved for treatment of ITP.
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- Agrawal M.. Textbook of Pediatrics. 3rd ed. — CBS Publishers,2025. — 973 p., 2025