COLONY STIMULATING
FACTOR
JOE SEBASTIAN THOMAS (52)
Definition
Colony Stimulating Factors are hematopoietic
growth factors that regulate the proliferation,
differentiation, and activation of
hematopoietic cells, especially white blood
cells. They are particularly used to combat
neutropenia induced by chemotherapy or
bone marrow failure.
Types and Examples
Types Examples Action
G-CSF Filgrastim, Stimulates
Pegfilgrastim, neutrophil
Lenograstim production and
funtcion
GM-CSF Sargramostim Stimulates
granulocytes
(neutrophils and
eosinophils) and
M-CSF Experimental macrophages
Stimulates
production of
IL-3 Experimental monocytes and
macrophages
Multiple
hematopoietic
Mechanism of action
CSFs bind to specific receptors on progenitor
cells in the bone marrow, activating
intracellular signaling cascades (e.g.,
JAK/STAT pathways) that promote
proliferation and maturation of myeloid
lineage cells, especially neutrophils.
Therapeutic uses
1. Chemotherapy-induced neutropenia – To
reduce incidence, severity, and duration of
neutropenia.
2. Bone marrow transplantation – To accelerate
neutrophil recovery.
3. Peripheral blood stem cell mobilization – For
harvesting progenitor cells.
4. Chronic neutropenia – Congenital, cyclic, or
idiopathic forms.
5. HIV-associated neutropenia
6. Myelodysplastic syndromes (GM-CSF in
particular)
Adverse Drug Reactions
Common ADRs :
• Bone pain (most common) •Fever, fatigue •Nausea
•Headache *Injection site reactions
Serious ADRs :
• Splenic rupture (rare, associated with G-CSF)
•Leukocytosis
•Allergic/anaphylactic reactions •Capillary leak
syndrome (mainly with GM-CSF) •Acute respiratory
distress syndrome (ARDS) *Hypotension and edema (with
sargramostim)
G-CSF AND GM-CSF
G-CSF GM-CSF
Neutrophils, monocytes and
Neutrophils only eosinophils.
Better tolerated More systemic ADRs
Splenic rupture is rare but Less reported
possible.
Fever – less frequent More common