title: Prevention of febrile leucopenia after chemotherapy in high-risk breast cancer patients: no significant difference between granulocyte-colony stimulating growth factor or ciprofloxacin plus amphotericin B.
abstract: In a prospective randomized trial, 40 stage IV breast cancer patients undergoing intermediate high-dose chemotherapy (cyclophosphamide, 5-fluorouracil plus epirubicin or methotrexate), received either recombinant human G-CSF (rhG-CSF, group I) or ciprofloxacin and amphotericin B (CAB, group II) for prevention of febrile leucopenia (FL). In group I, seven of 18 patients developed FL (after 10/108 courses); in group II, seven of 22 patients (7/98 courses) (P = NS). Median hospitalization duration and costs were not different. RhG-CSF was 6.6 times more expensive per course than CAB. In conclusion, prophylactic CAB has similar efficacy to rhG-CSF in this setting, and is more cost-effective.
authors.affiliation: Department of Medical Oncology, University Hospital Groningen, The Netherlands.
authors.forename: C P
authors.initials: CP
authors.lastname: Schröder
authors.forename: E G
authors.initials: EG
authors.lastname: de Vries
authors.forename: N H
authors.initials: NH
authors.lastname: Mulder
authors.forename: P H
authors.initials: PH
authors.lastname: Willemse
authors.forename: D T
authors.initials: DT
authors.lastname: Sleijfer
authors.forename: G A
authors.initials: GA
authors.lastname: Hospers
authors.forename: W T
authors.initials: WT
authors.lastname: van der Graaf
mesh_terms: D000328:Adult; D000666:Amphotericin B / Q000191:economics / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy*; D002939:Ciprofloxacin / Q000191:economics / Q000627:therapeutic use*; D003365:Costs and Cost Analysis; D003520:Cyclophosphamide / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005334:Fever / Q000150:complications / Q000517:prevention & control; D005472:Fluorouracil / Q000008:administration & dosage; D016179:Granulocyte Colony-Stimulating Factor / Q000191:economics / Q000627:therapeutic use*; D006801:Humans; D007902:Length of Stay / Q000191:economics; D007970:Leukopenia / Q000139:chemically induced / Q000517:prevention & control*; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009426:Netherlands; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000191:economics / Q000627:therapeutic use
chemical_list: D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D015251:Epirubicin; D002939:Ciprofloxacin; D000666:Amphotericin B; D003520:Cyclophosphamide; D005472:Fluorouracil; D008727:Methotrexate