title: 2006 update of recommendations for the use of white blood cell growth factors: an evidence-based clinical practice guideline.
abstract: OBJECTIVE
  To update the 2000 American Society of Clinical Oncology guideline on the use of hematopoietic colony-stimulating factors (CSF).
  The Update Committee completed a review and analysis of pertinent data published from 1999 through September 2005. Guided by the 1996 ASCO clinical outcomes criteria, the Update Committee formulated recommendations based on improvements in survival, quality of life, toxicity reduction and cost-effectiveness.
  
  
  CONCLUSIONS
  The 2005 Update Committee agreed unanimously that reduction in febrile neutropenia (FN) is an important clinical outcome that justifies the use of CSFs, regardless of impact on other factors, when the risk of FN is approximately 20% and no other equally effective regimen that does not require CSFs is available. Primary prophylaxis is recommended for the prevention of FN in patients who are at high risk based on age, medical history, disease characteristics, and myelotoxicity of the chemotherapy regimen. CSF use allows a modest to moderate increase in dose-density and/or dose-intensity of chemotherapy regimens. Dose-dense regimens should only be used within an appropriately designed clinical trial or if supported by convincing efficacy data. Prophylactic CSF for patients with diffuse aggressive lymphoma aged 65 years and older treated with curative chemotherapy (CHOP or more aggressive regimens) should be given to reduce the incidence of FN and infections. Current recommendations for the management of patients exposed to lethal doses of total body radiotherapy, but not doses high enough to lead to certain death due to injury to other organs, includes the prompt administration of CSF or pegylated G-CSF.
authors: American Society of Clinical Oncology, Cancer Policy and Clinical Affairs, Alexandria, VA 22314, USA.
authors: Thomas J
authors: TJ
authors: Smith
authors: James
authors: J
authors: Khatcheressian
authors: Gary H
authors: GH
authors: Lyman
authors: Howard
authors: H
authors: Ozer
authors: James O
authors: JO
authors: Armitage
authors: Lodovico
authors: L
authors: Balducci
authors: Charles L
authors: CL
authors: Bennett
authors: Scott B
authors: SB
authors: Cantor
authors: Jeffrey
authors: J
authors: Crawford
authors: Scott J
authors: SJ
authors: Cross
authors: George
authors: G
authors: Demetri
authors: Christopher E
authors: CE
authors: Desch
authors: Philip A
authors: PA
authors: Pizzo
authors: Charles A
authors: CA
authors: Schiffer
authors: Lee
authors: L
authors: Schwartzberg
authors: Mark R
authors: MR
authors: Somerfield
authors: George
authors: G
authors: Somlo
authors: James C
authors: JC
authors: Wade
authors: James L
authors: JL
authors: Wade
authors: Rodger J
authors: RJ
authors: Winn
authors: Antoinette J
authors: AJ
authors: Wozniak
authors: Antonio C
authors: AC
authors: Wolff