Growth Factors for Treating Chronic Myelomonocytic Leukemia
Hematopoietic growth factors are hormone-like substances that stimulate bone marrow to produce blood cells. These substances occur naturally in the body, but scientists have found a way to make them in large amounts. This lets patients receive these factors in larger doses than would be produced by their own body.
Shortages of blood cells cause many of the symptoms in people with chronic myelomonocytic leukemia (CMML), and growth factors can help the blood counts become more normal.
Erythropoietin (Epo® or Procrit®), a growth factor that promotes red blood cell production, can help avoid transfusions of red blood cells in some patients. Recently it has been found that combining erythropoietin with a growth factor for white blood cells (G-CSF, Neupogen®, or filgrastim) improves the patient’s response to the erythropoietin. Darbepoetin (Aranesp®) is a long-acting form of erythropoietin. It works in the same way but can be given less often.
A drug called oprelvekin (Neumega®, interleukin-11, or IL-11) can be used to stimulate platelet production after chemotherapy and in some other diseases. This drug can help increase the platelet counts of some CMML patients for a time, but then the counts go back down again. For most patients, this drug is not very helpful.
More studies are being done to find the best way to predict which patients will benefit from growth factors and the best way to combine growth factors with each other and with other treatments, such as chemotherapy or hormones. Patients usually receive the growth factors through subcutaneous (under the skin) injections. Your health care team can give the injections, or you or your family members can learn to give them.
Last Medical Review: January 19, 2014 Last Revised: February 17, 2016
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