Perspectives on the use of cytokines in the management of infectious complications of cancer

Treatment of neoplastic diseases is followed by a variety of infectious complications. Neutro-penia and functional defects of phagocytes are common consequences of cancer and its treatment and contribute to an increased susceptibility to infections. Cytokines with hematopoietic growth stimulatory and/or immunoenhancing properties, such as granulocyte-macrophage colony-stim-ulating factor (GM-CSF), granulocyte colony-stimulating factor (G-CSF), interleukin-3, inter-feron-7, macrophage colony-stimulating factor, interleukin-1, and interleukin-6 have been shown to either have clinical utility in patients with cancer and neutropenia or offer the promise to do so. GM-CSF and G-CSF, for example, have been shown to reduce the incidence of fever and infectious complications in patients with cancer and neutropenia. The role of cytokines for the treatment of defined infections (e.g., invasive mycoses) is under investigation. The treatment of neoplastic diseases with more-intensive cytotoxic and immunosuppressive regimens has become in-creasingly common in recent years. The goal of this escala-tion in dosage and intensity has been to improve the cure rates of the underlying malignancy. Both serious infectiou