Chapter 6. Hematopoietic Growth Factors and Coagulation Factors

Summary

Hematopoiesis—the production of blood cells—is a tightly regulated system, exquisitely responsive to functional demands including infection, allergic reaction, immune challenge, hemorrhage, inflammation, and hypoxia. Beyond the production of blood cells, the integrity of the circulatory system also requires platelets, growth factors, and coagulation factors. Cells in the circulatory system sustain life by delivering oxygen and nutrients to tissue, clearing waste and pathogens, and recruiting humoral and cellular host defenses in a timely manner. This chapter provides an overview of hematopoietic development of blood cells, followed by a discussion of how hematopoietic factors and coagulation factors are used to treat a number of blood disorders. Details on the use of individual hematopoietic growth factors and coagulation factors are included as monographs. The most important blood product approved up until now is erythropoietin. It has vastly improved the management of renal failure patients and ameliorated the anemia associated with cancer chemotherapy. Recombinant clotting factors are a more modest advance promising greater purity and lower risk of viral contamination than extracted products. The overall benefits of colony-stimulating factors to reduce the risk of neutropenia in patients with cancer who receive chemotherapy remain controversial.