Overview
Hematopoietic growth factors and cytokines regulate proliferation, differentiation, and release of blood cells.
Classification
| Factor | Primary lineage | Laboratory correlate |
|---|---|---|
| Erythropoietin | Erythroid | Reticulocyte rise; Hgb lag |
| Thrombopoietin | Megakaryocytic | Platelet count increase |
| G-CSF | Neutrophilic | Neutrophilia; left shift |
| GM-CSF | Granulocyte-monocyte | Mixed myeloid effects |
| IL-7 | Lymphoid | Lymphopoiesis support |
Morphologic Features
Therapy-related left shift should be documented when medication known, blasts still excluded per protocol.
Laboratory Characteristics
- Medication history part of interpretation
- Exogenous EPO and TPO-receptor agonists in select clinical settings
Reference Intervals
Serum EPO assays exist in specialized workflows, not routine on all CBC orders.
Clinical and Laboratory Significance
- Unexpected blasts despite G-CSF, alternate investigation
- Low EPO response, renal disease and other causes in later modules
Differential Considerations
Cytokine effects are lineage-predominant, multilineage abnormality needs broader workup.
Comparison Tables
Exogenous therapy patterns (when known)
| Therapy | Expected CBC shift |
|---|---|
| G-CSF | ↑ WBC/ANC; left shift |
| EPO | ↑ reticulocytes then Hgb |
| TPO agonist | ↑ platelets |
Classification Frameworks
Not applicable.
Laboratory Notes
- Magnitude of response varies, clinical context essential.
References
Authoritative textbooks, guidelines, and reviews supporting this reference entry. Verify reference intervals, critical limits, and reflex criteria against institutional protocols and current guideline editions.
Textbooks
- McPherson RA, Pincus MR. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Elsevier; 2021.
- Rodak BF, Carr JH. Rodak's Hematology: Clinical Principles and Applications. 6th ed. Elsevier; 2020.
- Hoffbrand AV, Moss PAH, Pettit JE. Essential Haematology. 8th ed. Wiley-Blackwell; 2019.
- McKenzie SB, Williams JL. Clinical Laboratory Hematology. 4th ed. Pearson; 2022.
Professional Monographs
- Barnes PW, McFadden SL, Machin SJ, Doig K. Laboratory Hematology Practice. Wiley-Blackwell; 2012.
CLSI and Professional Guidelines
- Clinical and Laboratory Standards Institute. Defining, Establishing, and Verifying Reference Intervals in the Clinical Laboratory; Approved Standard. CLSI document EP28-A3c. CLSI; 2010.
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