Granulocyte colony-stimulating factor (G-CSF) has been used in the clinic for more than 2 decades to treat congenital and acquired neutropenias and to reduce febrile neutropenia before or during courses of intensive cytoreductive therapy. In addition, healthy stem cell donors receive short-term treatment with G-CSF for mobilization of hematopoietic stem cells. G-CSF has also been applied in priming strategies designed to enhance the sensitivity of leukemia stem cells to cytotoxic agents, in protocols aimed to induce their differentiation and accompanying growth arrest and cell death, and in severe aplastic anemia and myelodysplastic syndrome (MDS) to alleviate anemia. The potential adverse effects of G-CSF administration, particularly the risk of malignant transformation, have fueled ongoing debates, some of which can only be settled in follow-up studies extending over several decades. This specifically applies to children with severe congenital neutropenia who receive lifelong treatment with G-CSF and in which the high susceptibility to develop MDS and acute myeloid leukemia (AML) has now become a major clinical concern. Here, we will highlight some of the controversies and challenges regarding the clinical application of G-CSF and discuss a possible role of G-CSF in malignant transformation, particularly in patients with neutropenia harboring mutations in the gene encoding the G-CSF receptor.

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Keywords Anemia, Aplastic, Animals, Cell Death, Cell Differentiation, Cell Transformation, Child, Drug Resistance, Granulocyte Colony Stimulating Factor, Recombinant, Hematopoietic Stem Cell Mobilization, Humans, Leukemia, Myeloid, Acute, Living Donors, Mutation, Myelodysplastic Syndromes, Neoplasm, Neoplastic, Neoplastic Stem Cells, Neutropenia, Preschool, Receptors, Granulocyte Colony-Stimulating Factor, Risk Factors, acute granulocytic leukemia, animal, aplastic anemia, cancer stem cell, cell death, cell differentiation, cell transformation, chemically induced disorder, child, drug effect, drug resistance, genetics, granulocyte colony stimulating factor receptor, human, living donor, metabolism, methodology, mutation, myelodysplastic syndrome, neutropenia; pathology, preschool child, recombinant granulocyte colony stimulating factor, review, risk factor, stem cell mobilization
Persistent URL dx.doi.org/10.1182/blood-2010-01-234120, hdl.handle.net/1765/20239
Citation
Beekman, R., & Touw, I.P.. (2010). G-CSF and its receptor in myeloid malignancy.. Blood, 115(25), 5131–5136. doi:10.1182/blood-2010-01-234120