Review of the value of colony stimulating factors for prophylaxis of febrile neutropenic episodes in adult patients treated for haematological malignancies

• Published in: British journal of haematology Vol. 138; no. 2; pp. 146 - 152
• Main Authors: Levenga, Tjakiena Henriette, Timmer‐Bonte, Johanna N. H.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.07.2007; Blackwell
• Subjects: Adult; Biological and medical sciences; chemotherapy; Colony-Stimulating Factors - economics; Colony-Stimulating Factors - therapeutic use; Cost-Benefit Analysis; febrile neutropenia; Fever - chemically induced; Fever - prevention & control; granulocyte colony‐stimulating factor; haematological malignancy; Hematologic and hematopoietic diseases; Hematologic Neoplasms - drug therapy; Humans; Leukemia, Myeloid, Acute - drug therapy; Lymphoma - drug therapy; Medical sciences; Myelodysplastic Syndromes - drug therapy; Neutropenia - chemically induced; Neutropenia - prevention & control; Other diseases. Hematologic involvement in other diseases; Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy; prophylaxis; Randomized Controlled Trials as Topic; Stem Cell Transplantation - methods; Human; Leukopenia; Hematology; Malignant hemopathy; Review; febrile neutropenia; granulocyte colony-stimulating factor; Colony stimulating factor; prophylaxis; Fever; Prevention; Chemotherapy; Granulocyte colony stimulating factor; Treatment; Adult; haematological malignancy; Bibliographic review; Neutropenia
• ISSN: 0007-1048; 1365-2141
• DOI: 10.1111/j.1365-2141.2007.06653.x

Summary Chemotherapy‐induced neutropenia is a major dose‐limiting toxicity of systemic cancer chemotherapy that can lead to fever and infection, requiring prompt analysis and in‐patient treatment with broad‐spectrum antibiotics. Complicated neutropenia may lead to reduction and/or delay of systemic anti‐cancer treatment, which may compromise outcome. Haematopoietic growth factors have the ability to augment haematopoietic cell cycling and are used to facilitate more dose‐intense treatments and to decrease treatment‐related complications. This review focuses on randomised trials that investigated the use of colony‐stimulating factors (CSF) to prevent treatment‐related febrile complications in haematological malignancies in (younger) adult patients. In general, these studies demonstrated that CSF reduced the duration of severe neutropenia but not always its febrile complications; therefore inconsistent results regarding clinically relevant reduction of hospitalisation, duration of therapeutic antibiotics, infection‐related or disease‐related mortality and economic effects were reported. Current developments in treatment of haematological malignancies will pose new challenges as a shift in infectious pathogens can be expected.