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Gary H. Lyman and David C. Dale

granulocyte colony-stimulating factor (G-CSF). This article focuses on the long-term benefits and risks associated with G-CSF therapy, including data for other myeloid factors, as available. Chemotherapy-Induced Neutropenia G-CSF reduces neutropenic

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Leila Family, Yanli Li, Lie Hong Chen, John H. Page, Zandra K. Klippel and Chun Chao

, chemotherapy agents, or cycle length; (2) received prophylactic granulocyte colony-stimulating factor (G-CSF) within 4 days of chemotherapy initiation and/or antibiotics prophylaxis dispensed between 3 days before and 10 days after first chemotherapy

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David C. Dale

colony-stimulating factor on the neutrophil response and peripheral blood colony-forming cells in healthy young and elderly adult volunteers . Blood 1994 ; 84 : 2923 – 2929 . 7 Price TH Chatta GS Dale DC . Effect of recombinant granulocyte

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Gary H. Lyman and Marek S. Poniewierski

treatment delays, and subsequently compromise disease control and overall survival. 2 – 6 The myeloid growth factors (MGFs), including granulocyte colony-stimulating factor (G-CSF), have been shown to decrease the risk of neutropenic complications

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Anne K. Hubben, Nathan Pennell, Marc Shapiro, Craig Savage and James P. Stevenson

Purpose: National guidelines do not include routine pGCSF as primary prophylaxis (PP) for patients receiving chemotherapy associated with a low risk for febrile neutropenia (FN). Inappropriate pGCSF can increase patient morbidity, financial burden, and overall health care costs. In 2013, an interdisciplinary group at TCI implemented a QI project to reduce inappropriate PP pGCSF in patients with lung cancer; this included prescriber education and modification of chemotherapy orders by risk of FN in the electronic medical record (EMR). Inappropriate pGCSF was reduced from 28% to 4%. In this 5-year follow up study we analyzed pGCSF use in lung cancer patients. Methods: We conducted a review of lung cancer patients who received pGCSF with chemotherapy initiated between January 2016 and August 2018. PP pGCSF use was appropriate if prescribed with chemotherapy regimens with a high risk (>20%) for FN, or intermediate risk (10%–20%) if other accepted FN risk factors were present. PP use with FN low-risk (<10%) chemotherapy was considered inappropriate. Treating physicians were anonymously surveyed about their practices. Results: 294 patients with lung cancer received 1,353 doses of pGCSF during the study period. 58 (20%) were treated at TCI by subspecialty thoracic oncologists and 236 (80%) were treated at regional network sites. 100/294 (34%) patients received low-risk regimens. 62/100 (62%) patients treated with low-risk regimens received 311 doses of PP pGCSF (inappropriate use). 5/62 (8%) of inappropriate use occurred at TCI; 57/62 (92%) at network sites. Of 130 patients who received an intermediate risk regimen, 99 (76%) received PP pGCSF. At least one risk factor for FN was identified in 80/99 (80%) of these patients; age >65 and prior chemotherapy or radiation were the top-cited factors. 33/294 (11%) patients were hospitalized for FN during the study period; 7/100 (7%) received low-risk regimens, 15/130 (11.5%) intermediate-risk, and 11/46 (24%) high-risk regimens. All physicians responding to the survey indicated awareness of guidelines and EMR risk identification. Conclusion: After initial success at our center, we found that guideline-based alignment of pGCSF prescribing in lung cancer patients was not sustained. Despite reported familiarity with guidelines for PP pGCSF use, this analysis suggests an opportunity for re-education and further EMR modification. Based on July 2018 CMS average sales price, reduction in inappropriate use presents a potential cost savings of $1.5 million during the study.

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Lee S. Schwartzberg and Sarah L. Blair

: AC, anthracycline/cyclophosphamide; CMF, cyclophosphamide/methotrexate/fluorouracil; doc, docetaxel; G-CSF, granulocyte colony-stimulating factor; pts, patients; T, paclitaxel; TC, docetaxel/cyclophosphamide; TCH, docetaxel

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Olga Frankfurt and Martin S. Tallman

; 11 : 466 – 478 . 3. Lieschke GJ Grail D Hodgson G . Mice lacking granulocyte colony-stimulating factor have chronic neutropenia, granulocyte and macrophage progenitor cell deficiency, and impaired neutrophil mobilization . Blood 1994

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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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Pamela S. Becker

dosing of cytokines and receptor antagonists. Granulocyte colony-stimulating factor (G-CSF) causes release of proteases, including neutrophil elastase, which cleaves CXCR4 and VCAM-1, 8 , 9 and elevated levels of metalloproteinases, including MMP-2 (that

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David da Silva Dias, Catarina Jorge, Mafalda Baptista, Ana Júlia Arede, Paulo Luz, Tânia Madureira and Beatriz Gosalbez

observed in 43% and severe neutropenia in 36%. Overall mortality rate was 13%. Sepsis was diagnosed in 24 patients (11%), with a mortality rate of 54%. Only 12.3% of patients had prophylaxis with granulocyte-colony stimulating factor. At admission, 64% of