24. Colony-stimulating factors

  1. Ross Pinkerton MB, BCh, BaO, MD Executive Director, Division of Oncology2,
  2. Ananth Shankar MD, FRCPCH Consultant in Paediatric and Adolescent Oncology3 and
  3. Katherine K. Matthay BA, MD Mildred V. Strouss Professor of Translational Oncology, Director, Pediatric Hematology-Oncology4
  1. Ananth Shankar

Published Online: 8 MAY 2013

DOI: 10.1002/9781118625309.ch24

Evidence-Based Pediatric Oncology

Evidence-Based Pediatric Oncology

How to Cite

Shankar, A. (2013) Colony-stimulating factors, in Evidence-Based Pediatric Oncology (eds R. Pinkerton, A. Shankar and K. K. Matthay), John Wiley & Sons, Ltd, Oxford. doi: 10.1002/9781118625309.ch24

Editor Information

  1. 2

    Royal Children's Hospital, Children's Health Queensland, Brisbane, QLD, Australia

  2. 3

    University College London Hospitals NHS Foundation Trust London, UK

  3. 4

    Department of Pediatrics, UCSF School of Medicine and, UCSF Benioff Children's Hospital, San Francisco, CA, USA

Author Information

  1. University College London Hospitals NHS Foundation Trust, London, UK

Publication History

  1. Published Online: 8 MAY 2013
  2. Published Print: 20 MAY 2013

ISBN Information

Print ISBN: 9780470659649

Online ISBN: 9781118625309



  • chemotherapy;
  • colony-stimulating factors (CSFs);
  • erythropoietin (EPO);
  • granulocyte colony-stimulating factors (G-CSFs);
  • granulocyte macrophage colony stimulating factor (GM-CSF);
  • myelosuppression


Myelosuppression is a common adverse consequence of the administration of many standard-dose chemotherapy regimens for both young and elderly patients with cancer. Since the introduction of growth factors several decades ago, there have been numerous clinical trials investigating the potential benefits of adjunctive therapy with colony-stimulating factors (CSFs), the objective being amelioration or prevention of profound neutropenia and its potentially life-threatening infections. Granulocyte colony-stimulating factors (G-CSFs) have led to improved delivery of fulldose chemotherapy at a planned schedule. While G-CSF is a lineage specific factor that regulates neutrophil production alone, granulocyte macrophage colony stimulating factor (GM-CSF) is a multilineage factor and activates neutrophils, eosinophils and monocyte/macrophages and is theoretically more effective than G-CSF. Erythropoietin (EPO) is effective at reducing transfusion requirements and it may be used in this setting when patients are unable to receive blood products for religious reasons.