title: G-CSF in solid tumor chemotherapy: a tailored regimen reduces febrile neutropenia, treatment delays and direct costs.
abstract: BACKGROUND
  Current guidelines do not recommend G-CSF for patients with risk factors for neutropenia.
  
  
  METHODS
  One-hundred patients undergoing chemotherapy were randomized to treatment with G-CSF at 5 Kg/kg for established febrile neutropenia (ANC <1000/microl) (Group A) or G-CSF at 263 Kg/day if ANC was 1500/microl or less on the day of the expected nadir, with the duration of treatment determined by the severity of neutropenia (Group B).
  
  
  RESULTS
  The number of doses of G-CSF was similar in the two groups. There were 34 cases of febrile neutropenia in Group A, but none in Group B (p=0.0001). Hospital admission for febrile neutropenia, antibiotic use and delays in chemotherapy were all significantly more common in Group A. Total direct costs were estimated to be 66, 646 for Group A and 47, 119 for Group B.
  
  
  CONCLUSIONS
  Tailoring treatment does not increase G-CSF use, but significantly reduces febrile neutropenia and treatment delays and lowers direct costs.
authors.affiliation: Medical Oncology Unit, Laikon General Hospital, Athens University School of Medicine, Athens 115 27, Greece. tsavari1@otenet.gr
authors.forename: Nicolas
authors.initials: N
authors.lastname: Tsavaris
authors.forename: Christos
authors.initials: C
authors.lastname: Kosmas
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Gouveris
authors.forename: Maria
authors.initials: M
authors.lastname: Vadiak
authors.forename: Antonis
authors.initials: A
authors.lastname: Dimitrakopoulos
authors.forename: Dimitra
authors.initials: D
authors.lastname: Karadima
authors.forename: Efterpi
authors.initials: E
authors.lastname: Pagouni
authors.forename: George
authors.initials: G
authors.lastname: Panagiotakopoulos
authors.forename: Evanthia
authors.initials: E
authors.lastname: Tzima
authors.forename: Sevasti
authors.initials: S
authors.lastname: Ispoglou
authors.forename: Dimitris
authors.initials: D
authors.lastname: Sakelariou
authors.forename: Christos
authors.initials: C
authors.lastname: Koufos
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000191:economics; D004334:Drug Administration Schedule; D005260:Female; D005334:Fever / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage* / Q000191:economics; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D009503:Neutropenia / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D009504:Neutrophils / Q000166:cytology / Q000187:drug effects
chemical_list: D016179:Granulocyte Colony-Stimulating Factor