Review of the value of colony stimulating factors for prophylaxis of febrile neutropenic episodes in adult patients treated for haematological malignancies.
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.
Levenga
Tjakiena Henriette
TH
Haematology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Timmer-Bonte
Johanna N H
JN
D000328:Adult; D003115:Colony-Stimulating Factors / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D005334:Fever / Q000139:chemically induced / Q000517:prevention & control*; D019337:Hematologic Neoplasms / Q000188:drug therapy*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy; D008223:Lymphoma / Q000188:drug therapy; D009190:Myelodysplastic Syndromes / Q000188:drug therapy; D009503:Neutropenia / Q000139:chemically induced / Q000517:prevention & control*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy; D016032:Randomized Controlled Trials as Topic; D033581:Stem Cell Transplantation / Q000379:methods
D003115:Colony-Stimulating Factors