Use in Febrile Neutropenic Patients

The ASCO guideline cites eight randomized control clinical trials that collectively do not support the routine use of CSFs in uncomplicated fever and neutropenia. They do, however, indicate the potential use of CSFs in high-risk, poor-prognosis patients with febrile neutropenia, including patients with an absolute neutrophil count (ANC) < 0.1 x 109/L, uncontrolled primary disease, pneumonia, hypotension, multiorgan dysfunction, invasive fungal infection, and advanced age. Similar recommendations are made by the ESMO guidelines.

Alternative preventative approaches suggested by the guidelines include chemotherapy dose reduction or the use of less myelosuppressive chemotherapy in noncurative regimes. The guidelines do not recommend antibiotic prophylaxis.

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