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 get larger doses of these growth factors than their body would make. Growth factor drugs are usually given by subcutaneous (under the skin) injections (shots).

Shortages of blood cells cause many of the symptoms in people with chronic myelomonocytic leukemia (CMML), and growth factors can help keep blood counts at more normal levels.

Erythropoietin (Epo^® or Procrit^®) is a growth factor that promotes red blood cell production. It can help some patients avoid getting a lot of red blood cell transfusions. Sometimes erythropoietin is given along with a growth factor for white blood cells (G-CSF, Neupogen^®, or filgrastim) to improve 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. This drug can help increase the platelet counts of some CMML patients for a time, but then the counts go down again. For most people with CMML, this drug is not very helpful.