The use of myeloid hematopoietic growth factors in patients with HIV infection.

Hematologic abnormalities are frequent occurrences in patients with HIV infection. Myelosuppression in AIDS may be due to multiple factors and has significant impact on the treatment of HIV-infected individuals, as it is the major dose-limiting toxicity of a number of antimicrobial compounds and chemotherapy. Both granulocyte-macrophage colony-stimulating factor (GM-CSF) and granulocyte colony-stimulating factor (G-CSF) are hematopoietic hormones which effect myeloid progenitor cells and enhance the function of mature neutrophils. Clinical studies of the effects of these agents in patients with AIDS indicate that GM-CSF and G-CSF can increase the production of leukocytes in a dose-dependent fashion. This increase in leukocyte production may allow the continued administration of full doses of antiviral or other myelosuppressive medications in previously hematologically intolerant patients with AIDS. Investigations of the hematopoietic, virologic, and immunologic effects of these agents alone and in combination with other hematopoietins, cytokines, and chemotherapeutic agents will ultimately define their clinical utility in patients with HIV infection.