Cytokine therapy after bone marrow transplantation.

Granulocyte-macrophage colony-stimulating factor (GM-CSF) and granulocyte colony-stimulating factor (G-CSF) have an important yet controversial role in the care of patients undergoing bone marrow transplantation (BMT). Numerous studies have documented acceleration of neutrophil recovery by the agents. Because of the differences and lack of published clinical outcomes and of direct comparisons of the two CSFs, coupled with limited data from phase III trials, it is difficult to draw conclusions from the literature on the use of the agents after BMT. Issues that must be critically evaluated are toxicity profile, dose, initiation and duration of administration, route of administration, and cost.