Growth Factors and Similar Medicines for Chronic Myelomonocytic Leukemia

Giving a person growth factor drugs is one way to raise low blood cell counts. But transfusions of blood components (red blood cells or platelets) are typically used more often. Growth factor drugs are usually given by subcutaneous (under the skin) injections.

Growth factors to raise red blood cell levels

Epoetin alfa (Epogen or Retacrit) is a manmade version of the growth factor erythropoietin, which tells the body to make more red blood cells. It can often help lower the number of red blood cell transfusions a person needs. Giving both epoetin and G-CSF (see "Growth factors to raise white blood cells") can sometimes improve the person's response to epoetin.

Darbepoetin alfa (Aranesp) is a long-acting form of epoetin. It works in the same way can be given less often.

Luspatercept (Reblozyl) isn’t a growth factor, but it is another medicine that can help the body make more healthy red blood cells. Known as a red blood cell maturation agent, this drug affects TGF-β proteins in the bone marrow. TGF-β proteins normally help control how quickly new cells in the bone marrow mature into functioning red blood cells, so that there aren’t too many or too few of them in the body. By acting on specific TGF-β proteins, luspatercept helps the bone marrow make more healthy, fullgrown red blood cells.

Growth factors to raise white blood cell levels

Granulocyte colony stimulating factor (G-CSF, filgrastim, Neupogen or other brand names) can improve white blood cell production. This is not used routinely to prevent infections, but it can help some patients whose main problem is a shortage of white blood cells and who have frequent infections.

Pegfilgrastim (Neulasta, other brand names) is a long-acting form of G-CSF. It works in the same way but can be given less often.

Medicines to raise blood platelet levels

Drugs called thrombopoietin-receptor agonists, such as romiplostim (Nplate) and eltrombopag (Promacta) might help some people with CMML who have very low platelet levels.

A drug called oprelvekin (interleukin-11, IL-11, or Neumega) can be used to raise platelet counts after chemotherapy and in some other diseases. But for most people with CMML, this drug has not been found to be very helpful.