Myeloid Growth Factors

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Myeloid Growth Factors Clinical Practice Guidelines in Oncology NCCN Categories of Evidence and Consensus Category 1: The recommendation is based on high-level evidence (e.g., randomized controlled trials) and there is uniform NCCN consensus. Category 2A: The recommendation is based on lower-level evidence and there is uniform NCCN consensus. Category 2B: The recommendation is based on lower-level evidence and there is nonuniform NCCN consensus (but no major disagreement). Category 3: The recommendation is based on any level of evidence but reflects major disagreement. All recommendations are category 2A unless otherwise noted. Clinical trials: The NCCN believes that the best management for any cancer patient is in a clinical trial. Participation in clinical trials is especially encouraged. Overview Neutropenia (< 500 neutrophils/mcL or < 1000 neutrophils/mcL and a predicted decline to ≤ 500/mcL over the next 48 hours) and resulting febrile neutropenia (FN; ≥ 38.3°C orally or ≥ 38.0°C over 1 hour) can be induced by myelosuppressive chemotherapy. FN is a major dose-limiting toxicity of chemotherapy, often necessitating hospitalization for evaluation and empiric broad-spectrum antibiotics. These complications often result in dose reductions or treatment delays, which may compromise clinical outcomes. The prophylactic use of colony-stimulating factors (CSFs) can reduce the risk, severity, and duration of FN. Despite these benefits, CSFs are not administered to all patients under going myelosuppressive chemotherapy because of the costs associated with routine use. Selective use of CSFs in patients at increased risk for neutropenic complications may, however, enhance cost-effectiveness by directing treatment toward patients most likely to...

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