G-CSF in solid tumor chemotherapy: a tailored regimen reduces febrile neutropenia, treatment delays and direct costs.
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.
Tsavaris
Nicolas
N
Medical Oncology Unit, Laikon General Hospital, Athens University School of Medicine, Athens 115 27, Greece. tsavari1@otenet.gr
Kosmas
Christos
C
Gouveris
Panagiotis
P
Vadiak
Maria
M
Dimitrakopoulos
Antonis
A
Karadima
Dimitra
D
Pagouni
Efterpi
E
Panagiotakopoulos
George
G
Tzima
Evanthia
E
Ispoglou
Sevasti
S
Sakelariou
Dimitris
D
Koufos
Christos
C
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
D016179:Granulocyte Colony-Stimulating Factor