Clinical Benefits of Improving Host Defences with rHuG-CSF

  1. Gregory R. Bock Organizer and
  2. Jamie A. Goode
  1. George Morstyn1,
  2. Mary Ann Foote1 and
  3. Steve Nelson2

Published Online: 28 SEP 2007

DOI: 10.1002/9780470515280.ch6

Ciba Foundation Symposium 204 - The Molecular Basis of Cellular Defence Mechanisms

Ciba Foundation Symposium 204 - The Molecular Basis of Cellular Defence Mechanisms

How to Cite

Morstyn, G., Foote, M. A. and Nelson, S. (2007) Clinical Benefits of Improving Host Defences with rHuG-CSF, in Ciba Foundation Symposium 204 - The Molecular Basis of Cellular Defence Mechanisms (eds G. R. Bock and J. A. Goode), John Wiley & Sons, Ltd., Chichester, UK. doi: 10.1002/9780470515280.ch6

Author Information

  1. 1

    Amgen Inc., 1840 Dehavilland Drive, Thousand Oaks, CA 91320–1789, USA

  2. 2

    LSU Medical Center, New Orleans, LA, USA

Publication History

  1. Published Online: 28 SEP 2007

ISBN Information

Print ISBN: 9780471965671

Online ISBN: 9780470515280

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Keywords:

  • host defences;
  • rHuG-CSF;
  • acquired immunodeficiency syndrome (AIDS);
  • severe chronic neutropenia (SCN);
  • streptococcus pneumoniae

Summary

Recombinant human granulocyte colony-stimulating factor (rHuG-CSF) has been shown to stimulate the production and function of neutrophils in vitro and in vivo. Clinical studies in patients receiving myelosuppressive chemotherapy showed earlier neutrophil recovery, a reduction in infectious complications of neutropenia, and the use of fewer antibiotics. Its use has also been established for mitigating the infectious complications associated with severe chronic neutropenia (SCN). Data are emerging that neutropenia also contributes to the risk of infections in patients with acquired immunodeficiency syndrome (AIDS) and in neonates with presumed sepsis, and that rHuG-CSF may be a useful adjunct therapy in these patients. More recent studies have focused on enhancing neutrophil number and function in patients with infections not associated with neutropenia. These studies were approached cautiously because of the suggestion that neutrophils might non-selectively amplify the body's inflammatory response in the immunocompetent host and lead to inadvertent tissue injury. Preclinical models have provided a strong rationale for clinical studies to determine whether rHuG-CSF lessens the severity or duration of serious infections or their complications in patients with suboptimal outcome from antibiotics. These studies suggest that elevation of neutrophil levels in these settings is not only safe but has clinical benefit.