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Epidemiology
Febrile neutropenia is a major dose-limiting toxicity of chemotherapy. Studies have demonstrated that selective use of colony-stimulating factors (CSFs) in patients at high-risk for complications of neutropenia can enhance cost-effectiveness by reducing the risk, severity and duration of febrile neutropenia
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NCI Common Terminology Criteria for Adverse Events (CTCAE) Version 4.0 Neutrophil Count Decreased3
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Examples of Regimens with >20% Risk of Febrile Neutropenia2
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Treatment Overview
NCCN Guidelines® (V.1.2013)2 and ASCO Guidelines (2006 Update)5 recommend routine use of CSFs support for patients at high risk (defined >20%) of developing febrile neutropenia who are receiving treatment with curative intent, adjuvant therapy, or treatment expected to prolong survival or to improve quality of life (QOL)2,5
ASCO Guidelines also recommends CSFs for:
Patients with diffuse aggressive lymphomas aged ≥65 years treated with curative chemotherapy (CHOP or more aggressive regimens)
Patients exposed to lethal doses of total-body irradiation (TBI) (CSFs or pegylated G-CSF)5
NCCN Guidelines (V.1.2013) also recommend evaluation of patients for the use of myeloid growth factors before every cycle of cytotoxic chemotherapy
If febrile neutropenia or a dose-limiting neutropenic event previously occurred during chemotherapy without CSFs use, the guidelines recommend considering CSFs use during repeated treatment cycles
If fever with neutropenia or a dose-limiting ...