The application of hematopoietic growth factors mainly contributes to the rise in costs of chemotherapy for cancer patients. Therefore, cost/benefit analysis must carefully be performed whenever the two most frequently used growth factors, G-CSF (granulocyte colony-stimulating factor) and GM-CSF (granulocyte-macrophage colony-stimulating factor) are applied. Their use in the primary prevention of febrile neutropenia (FNP) can only be recommended when the chance for the occurrence of an FNP exceeds 40%. In secondary prophylaxis they may reasonably be applied if previous cycles of chemotherapy have led to severe infections such as pneumonia or sepsis during FNP, or in cases in which prolonged episodes of cytopenia inhibit the application of cyctotoxic drugs in time and if simultaneously dose intensity mainly contributes to the success of chemotherapy. In situations where severe infections complicate neutropenia, G- and GM-CSF together with antibiotics may be considered helpful. Further important areas for colony-stimulating factors are their use in peripheral stem cell mobilization for autologous transplantation as well as the treatment of graft failure after autologous or allogeneic stem cell transplantation. However, application in myeloid neoplasias or use of CSFs immediately before or simultaneously with chemotherapy remains a matter of research and debate.

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1999
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