title: Granulocyte colony-stimulating factors used in clinical practice: PoloNord Registry-Based Cohort Italian Study.
abstract: OBJECTIVE
  Granulocyte colony-stimulating factors are widely used to reduce myelotoxicity of chemotherapy and to allow its regular administration. National and international guidelines regulate their use. The aim of the study was to evaluate the use of pegfilgrastim and filgrastim/lenograstim in clinical practice, adherence to ASCO and ESMO guidelines, chemotherapy-related complications and adverse reactions.
  
  
  METHODS
  Data from 645 consecutive patients and 3,150 chemotherapy administrations, receiving granulocyte colony-stimulating factors, as primary/secondary prophylaxis or therapeutic use, for the first time during a line of chemotherapy, were recorded from 08/2008 to 08/2011, in 10 Lombardy Italian cancer centers. Patients and chemotherapy administrations data were examined in a multiple logistic regression analysis model.
  
  
  RESULTS
  Adherence to guidelines: primary prophylaxis, pegfilgrastim and filgrastim/ lenograstim 66%/47% (P = 0.002); secondary prophylaxis, 19.0%/26.8%; but 56.8%/ 53.6% including patients at high risk of febrile neutropenia with grade 3-4 neutropenia. Correct timing start (administration 24-72 h after chemotherapy): pegfilgrastim and filgrastim/lenograstim, 93.2%/61.5% (P <0.0001).
  
  
  CONCLUSIONS
  Results suggest the more correct administration of pegfilgrastim as primary prophylaxis and timing start, compared to filgrastim/lenograstim. In secondary prophylaxis, the use of granulocyte colony-stimulating factors is extended beyond guideline recommendations to support patients at high risk of febrile neutropenia and to guarantee dose intensity. These outcomes suggest both the need of educational activities and the development of predictive tools to better define high risk patients and the use of granulocyte colony-stimulating factors.
authors.forename: Daniele
authors.initials: D
authors.lastname: Fagnani
authors.forename: Luciano
authors.initials: L
authors.lastname: Isa
authors.forename: Magda Franca
authors.initials: MF
authors.lastname: Verga
authors.forename: Paola
authors.initials: P
authors.lastname: Nova
authors.forename: Clelia
authors.initials: C
authors.lastname: Casartelli
authors.forename: Virginio
authors.initials: V
authors.lastname: Filipazzi
authors.forename: Marco
authors.initials: M
authors.lastname: Danova
authors.forename: Gabriella
authors.initials: G
authors.lastname: Farina
authors.forename: Palma
authors.initials: P
authors.lastname: Pugliese
authors.forename: Sergio
authors.initials: S
authors.lastname: Fava
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bertolini
authors.forename: Claudio
authors.initials: C
authors.lastname: Cimminiello
authors.forename: Patrizia
authors.initials: P
authors.lastname: Boracchi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Marano
authors.forename: Claudia
authors.initials: C
authors.lastname: Panzarino
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy; D004338:Drug Combinations; D064147:Febrile Neutropenia / Q000139:chemically induced / Q000517:prevention & control*; D005260:Female; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D019983:Guideline Adherence; D006760:Hospitalization; D006801:Humans; D000078224:Lenograstim; D008175:Lung Neoplasms / Q000188:drug therapy; D008223:Lymphoma / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000627:therapeutic use; D012042:Registries; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D004338:Drug Combinations; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; C455861:pegfilgrastim; D011092:Polyethylene Glycols; D000078224:Lenograstim; D000069585:Filgrastim