The characteristics and clinical uses of recombinant
colony-stimulating factors (CSFs) are described, and the pharmacist's role as a consultant and educator on biotherapeutic substances is discussed. CSFs stimulate the formation and differentiation of the erythrocytes, neutrophils, eosinophils, basophils, monocytes, and platelets that compose the blood cell population. Recombinant CSFs represent a means by which the numbers of hematopoietic cells can be modulated, thus making these agents potentially useful in treating hematologic and immunologic deficiencies. CSFs also can increase the ability of neutrophils and monocyte-macrophages to protect the body against foreign invasion.
Granulocyte macrophage colony-stimulating factor (
GM-CSF) has increased host defenses in
acquired immunodeficiency syndrome patients with
Kaposi's sarcoma; increased neutrophil, platelet, and erythrocyte counts in preleukemic patients; and increased neutrophil counts in patients with
aplastic anemia.
GM-CSF and
granulocyte colony-stimulating factor (
G-CSF) have appeared to alleviate the drastic decrease in neutrophil counts associated with cytotoxic
chemotherapy.
G-CSF also has shown promise in stimulating neutrophil production in patients with
transitional cell carcinoma,
congenital agranulocytosis, and
hairy-cell leukemia. Mild adverse effects such as
fever,
chills,
rash,
fatigue,
myalgia, and bone
pain are associated with
GM-CSF therapy;
G-CSF therapy is associated mostly with mild to moderate bone
pain. Areas of education for pharmacists working with biotherapeutic substances include stability, storage temperature, drug interactions, novel drug-delivery systems such as
monoclonal antibodies or
liposomes, variations in
biologic activity, and the evolving nature of the information about these
investigational drugs. The pharmacist can anticipate an increasing role as a consultant on the use of CSFs and other biotherapeutic substances.(ABSTRACT TRUNCATED AT 250 WORDS)