Erythropoietin, G-CSF, and TPO are lineage-dominant hormones that have few other physiologic effects. In contrast, most other cytokines and interleukins display a multitude of activities, many of which mediate different aspects of the inflammatory response. As a consequence, the response to therapeutic administration of these sub-stances is complex and partially indirect, often resulting in many undesirable effects. The promise and failure of such biologicals as interleukin-1, interleukin-2, interleukin-3, interleukin-6, and tumor necrosis factor demonstrate this.74 Studies suggest that providers often overlook these options, resulting in suboptimal treatment of anemia and neutropenia in many cases.75 Although there are clear benefits to the use of CSFs to ameliorate cytopenias, there is yet no clear evidence of survival benefit.