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Boglarka Gyurkocza and Frederick R. Appelbaum

use of highly effective antiemetics, antibiotics, antifungals, and myeloid growth factors, have changed practice. The weight loss, debility, erosive esophagitis, and aspiration pneumonia once common with induction chemotherapy in older patients are now

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J. Sybil Biermann, Douglas R. Adkins, Robert S. Benjamin, Brian Brigman, Warren Chow, Ernest U. Conrad III, Deborah A. Frassica, Frank J. Frassica, Suzanne George, Kenneth R. Hande, Francis J. Hornicek, G. Douglas Letson, Joel Mayerson, Sean V. McGarry, Brian McGrath, Carol D. Morris, Richard J. O'Donnell, R. Lor Randall, Victor M. Santana, Robert L. Satcher, Herrick J. Siegel, Neeta Somaiah, and Alan W. Yasko

with appropriate growth factor support for 12 to 24 weeks (see the NCCN Clinical Practice Guidelines in Oncology: Myeloid Growth Factors for growth factor support; to view the most recent version of these guidelines, visit the NCCN Web site at www

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Katy Winckworth-Prejsnar, Elizabeth A. Nardi, Lisa Korin Lentz, Jeffrey A. Crawford, C. Lyn Fitzgerald, and Robert W. Carlson

given disease setting. 30 , 31 Dr. Crawford, chair of the NCCN Myeloid Growth Factors Panel, discussed NCCN category of evidence designation without clinical trial data for all indications of filgrastim-sndz. Within the NCCN Guidelines, although

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Stephen Harnicar

should be suspended and then reinitiated at a reduced dose of 300 mg. Data support the use of myeloid growth factors for patients with resistant neutropenia. 28 Grade 3 to 4 thrombocytopenia is managed similarly; therapy should be held until the platelet

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Pamela Sue Becker, Elizabeth A. Griffiths, Laura M. Alwan, Kimo Bachiashvili, Anna Brown, Rita Cool, Peter Curtin, Shira Dinner, Ivana Gojo, Ashley Hicks, Avyakta Kallam, Wajih Zaheer Kidwai, Dwight D. Kloth, Eric H. Kraut, Daniel Landsburg, Gary H. Lyman, Ryan Miller, Sudipto Mukherjee, Shiven Patel, Lia E. Perez, Adam Poust, Raajit Rampal, Rachel Rosovsky, Vivek Roy, Hope S. Rugo, Sepideh Shayani, Sumithira Vasu, Martha Wadleigh, Kelly Westbrook, Peter Westervelt, Jennifer Burns, Jennifer Keller, and Lenora A. Pluchino

., Inc. Overview Myeloid growth factors (MGFs), such as granulocyte colony-stimulating factors (G-CSFs), are hematopoietic growth factors (HGFs) that regulate the growth and differentiation of cells in the myeloid lineage. 1 Pharmacologic G-CSFs, such as

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Robert W. Carlson, Susan Moench, Arti Hurria, Lodovico Balducci, Harold J. Burstein, Lori J. Goldstein, William J. Gradishar, Kevin S. Hughes, Mohammad Jahanzeb, Stuart M. Lichtman, Lawrence B. Marks, Joan S. McClure, Beryl McCormick, Lisle M. Nabell, Lori J. Pierce, Mary Lou Smith, Neal S. Topham, Tiffany A. Traina, John H. Ward, and Eric P. Winer

evaluations of renal and hepatic functions, possible benefit of weekly dosing, and early use of myeloid growth factors were mentioned as important considerations. Some underexplored areas include evaluation of the pharmacokinetics and pharmacodynamics of

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Jerald P. Radich, Michael Deininger, Camille N. Abboud, Jessica K. Altman, Ellin Berman, Ravi Bhatia, Bhavana Bhatnagar, Peter Curtin, Daniel J. DeAngelo, Jason Gotlib, Gabriela Hobbs, Madan Jagasia, Hagop M. Kantarjian, Lori Maness, Leland Metheny, Joseph O. Moore, Arnel Pallera, Philip Pancari, Mrinal Patnaik, Enkhtsetseg Purev, Michal G. Rose, Neil P. Shah, B. Douglas Smith, David S. Snyder, Kendra L. Sweet, Moshe Talpaz, James Thompson, David T. Yang, Kristina M. Gregory, and Hema Sundar

saturation, vitamin B 12 , and folate and correction of nutritional deficiencies if present is recommended for patients with grade 3/4 anemia. Red blood cell transfusions are indicated in symptomatic patients. Myeloid growth factor support can be used in

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J. Sybil Biermann, Douglas R. Adkins, Mark Agulnik, Robert S. Benjamin, Brian Brigman, James E. Butrynski, David Cheong, Warren Chow, William T. Curry, Deborah A. Frassica, Frank J. Frassica, Kenneth R. Hande, Francis J. Hornicek, Robin L. Jones, Joel Mayerson, Sean V. McGarry, Brian McGrath, Carol D. Morris, Richard J. O'Donnell, R. Lor Randall, Victor M. Santana, Robert L. Satcher, Herrick J. Siegel, Margaret von Mehren, Mary Anne Bergman, and Hema Sundar

include appropriate growth factor support (see the NCCN Guidelines for Myeloid Growth Factors for growth factor support; to view the most recent version of these guidelines, visit NCCN.org ). A list of specific chemotherapy regimens is available in “Bone

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Gregory P. Kalemkerian, Wallace Akerley, Paul Bogner, Hossein Borghaei, Laura Chow, Robert J. Downey, Leena Gandhi, Apar Kishor P. Ganti, Ramaswamy Govindan, John C. Grecula, James Hayman, Rebecca Suk Heist, Leora Horn, Thierry M. Jahan, Marianna Koczywas, Cesar A. Moran, Harvey B. Niell, Janis O'Malley, Jyoti D. Patel, Neal Ready, Charles M. Rudin, and Charles C. Williams Jr.

recommended therapy for patients with limited-stage disease (category 1). 49 , 50 , 58 In combination with thoracic radiotherapy, EP causes an increased risk of esophagitis, pulmonary toxicity, and hematologic toxicity. 59 The use of myeloid growth factors

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Arti Hurria, Ilene S. Browner, Harvey Jay Cohen, Crystal S. Denlinger, Mollie deShazo, Martine Extermann, Apar Kishor P. Ganti, Jimmie C. Holland, Holly M. Holmes, Mohana B. Karlekar, Nancy L. Keating, June McKoy, Bruno C. Medeiros, Ewa Mrozek, Tracey O’Connor, Stephen H. Petersdorf, Hope S. Rugo, Rebecca A. Silliman, William P. Tew, Louise C. Walter, Alva B. Weir III, and Tanya Wildes

The EORTC issued similar recommendations for the prophylactic use of G-CSF in older patients with cancer. 218 The NCCN Guidelines for Myeloid Growth Factors address the use of G-CSFs in patients with solid tumors and nonmyeloid malignancies (to view