PubMed · 5926782
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E C Vigliani, A Forni. 1966-11-24. [Occupational leukemogenesis].. https://pubmed.ncbi.nlm.nih.gov/5926782/
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Granulocyte colony stimulating factor (G-CSF) is a naturally occurring potent neutrophil growth factor. Recombinant human G-CSF has been developed by pharmaceutical companies, and since the late 1980's, multiple clinical trials have explored its efficacy in a variety of medical conditions. These include various inherited and acquired neutropenia, as well as mobilization of hematopoietic stem cells and progenitors for transplantation. Interestingly, in several type of inherited neutropenia where no randomized controlled studies have ever been conducted, its chronic use is considered critical for survival and deemed a standard of care. Unfortunately, it the settings of cancer treatment-related neutropenia and post hematopoietic stem cell transplantation, controversy still prevails whether universal usage of drug is cost effective despite innumerous randomized clinical trials. This review will focus on the clinical applications of G-CSF in the setting of inherited and acquired bone marrow failure, cancer treatment-related neutropenia and hematopoietic stem cell transplantation.
Aplastic anemia (AA) is mediated by T-cell autoimmunity in the majority of cases; it is rare and mostly idiopathic in children. We describe a child, who developed AA following Graves' disease which could not be attributed to antithyroid drugs. We hypothesized that both diseases were caused by similar autoimmune process. We monitored the blood counts and did not administer any conventional treatment for AA assuming that the existing anti- hematopoietic stem cell humoral and cellular immunity might subside with induction of remission of Grave's disease. The child went into complete remission with the treatment of the Graves' disease.
Severe aplastic anemia is a well-recognized complication of fulminant non-A, non-B, and non-C hepatitis requiring orthotopic liver transplantation. The first line of therapy for cure in the treatment of aplastic anemia is a histocompatible bone marrow transplant. Immunosuppressive therapy is also effective if a histocompatible donor is not available. We describe two children who developed severe aplastic anemia following orthotopic liver transplant who achieved bone marrow recovery with a single course of anti-thymocyte globulin, solumedrol, and adjustments to their immunosuppressive therapy for prevention of liver allograft rejection.