Hematopoietic Growth Factors

Hematopoiesis is an intricate, well-regulated, and homeostatic multistep process that allows immature precursor cells in the bone marrow to proliferate, differentiate, mature, and become functional blood cells that transport oxygen and carbon dioxide; contribute to host immunity; and facilitate blood clotting. In the early 1900s, scientists recognized the presence of circulating factors that regulate hematopoiesis. Scientific progress was slow until it became possible to purify sufficient quantities to evaluate the characteristics and biologic potential of the isolated materials. The introduction of recombinant DNA technology triggered a flurry of studies and an information explosion, which confirmed that hematopoiesis is mediated by a series of hematopoietic growth factors that act individually and in various combinations involving complex feedback mechanisms. Today, many hematopoietic growth factors have been isolated; some have been studied extensively, and a few have been manufactured for clinical use. In this chapter, the HGF molecular structure and mechanism of action, its main pharmacokinetic and pharmacodynamic properties, as well as the clinical indications and main toxicities are described.