Review of the value of colony stimulating factors for prophylaxis of febrile neutropenic episodes in adult patients treated for haematological malignancies

Br J Haematol. 2007 Jul;138(2):146-52. doi: 10.1111/j.1365-2141.2007.06653.x.

Abstract

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.

Publication types

  • Review

MeSH terms

  • Adult
  • Colony-Stimulating Factors / economics
  • Colony-Stimulating Factors / therapeutic use*
  • Cost-Benefit Analysis
  • Fever / chemically induced
  • Fever / prevention & control*
  • Hematologic Neoplasms / drug therapy*
  • Humans
  • Leukemia, Myeloid, Acute / drug therapy
  • Lymphoma / drug therapy
  • Myelodysplastic Syndromes / drug therapy
  • Neutropenia / chemically induced
  • Neutropenia / prevention & control*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy
  • Randomized Controlled Trials as Topic
  • Stem Cell Transplantation / methods

Substances

  • Colony-Stimulating Factors