hematopoiesis. Cytokine therapy with recombinant human erythropoietin (rHuEPO) has resulted in clinically important erythroid responses in 20% of patients with MDS, which increases to 40% with addition of granulocyte colony-stimulating factor (rHuG-CSF). Identification of factors that predict response to these hematopoietic growth factors (HGFs) permits tailoring of these treatments to appropriate subsets of MDS patients. The rationale for using HGFs in AA has been to increase the pool of residual stem cells and to stimulate maturation of pre-existing progenitors in an attempt to ameliorate cytopenias; however, their prophylactic use as single agents has not been recommended. Instead, they have primarily been used as adjuncts to immunosuppressive therapy in the setting of clinical trials or in patients refractory to other therapies. Use of rHuG-CSF in AA has caused close scrutiny of the question as to whether the cytokine contributes to the increased risk of late clonal hematologic malignancies observed in a proportion of patients with AA.

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