Factores estimulantes de colonias de granulocitos (G-CSF): de la sincronización molecular a la oncología de precisión
Granulocyte colony-stimulating factors (G-CSF): from molecular synchronization to precision oncology
Resumen
RESUMEN
Introducción. El Factor estimulante de colonias de granulocitos (G-CSF) es el principal regulador de la granulopoyesis. Su uso racional es determinante para reducir la morbimortalidad asociada a la neutropenia febril posquimioterapia. Objetivo. Analizar los fundamentos moleculares, la cinética celular y las pautas de administración del G-CSF basadas en la evidencia más reciente. Contenido. Se discute el papel del eje CXCL12/CXCR4 en la movilización mieloide y la importancia crítica del inicio del fármaco (24-72 horas post-infusión) para evitar la mielosupresión paradójica. Se abordan escenarios complejos como la infusión continua (DA-EPOCH) y la radioterapia torácica. Asimismo, se evalúa el uso de antihistamínicos (loratadina) para el manejo del dolor óseo. Conclusiones. La transición hacia una oncología de precisión requiere optimizar la ventana terapéutica y personalizar la dosificación mediante biomarcadores y algoritmos predictivos para mejorar el pronóstico hematológico hacia el 2030.
ABSTRACT
Introduction. Granulocyte colony-stimulating factor (G-CSF) is the primary regulator of granulopoiesis. Its rational use is crucial for reducing the morbidity and mortality associated with post-chemotherapy febrile neutropenia. Objective. To analyze the molecular mechanisms, cellular kinetics, and administration regimens of G-CSF based on the most recent evidence. Content. The role of the CXCL12/CXCR4 axis in myeloid mobilization and the critical importance of the timing of drug initiation (24–72 hours post-infusion) to avoid paradoxical myelosuppression are discussed. Complex scenarios such as continuous infusion (DA-EPOCH) and thoracic radiation therapy are addressed. Furthermore, the use of antihistamines (loratadine) for the management of bone pain is evaluated. Conclusions. The transition toward precision oncology requires optimizing the therapeutic window and personalizing dosing using biomarkers and predictive algorithms to improve hematologic prognosis by 2030.
Recibido: 10-02-2026.
Aceptado: 17-03-2026.
Publicado: 29-05-2026
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Depósito Legal Electrónico: ME2016000090
ISSN Electrónico: 2610-797X
DOI: https://doi.org/10.53766/GICOS
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