Febrile neutropenia, colony-stimulating factors and therapy: time for a new methodology?

Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer
Graeme N ForrestAlan Cross

Abstract

The utilization of granulocyte colony-stimulating factors (G-CSF) in febrile neutropenia has been controversial for many years. Berghmann et al.'s meta-analysis again demonstrates that G-CSF does not have an impact on mortality in febrile neutropenia, because the depth and duration of neutropenia in the trials are variable. Also, with mortality from febrile neutropenia less than 15%, any further study would require a vast number of patients to demonstrate a difference in mortality. The Elting and Cantor review provides a new paradigm to studies in patients with febrile neutropenia. These authors recognize that cost, quality of life, life-years gained and adverse events experienced with new therapies should be evaluated, in addition to the standard measures of infection resolution and related mortality. Therefore, for the evaluation of new therapeutic interventions, a consensus on stratified risk factors or the use of an already established model could provide end-points with comparable measurements.

Citations

Dec 10, 2013·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Alexandre ChanLi Yang Hsu
Dec 4, 2012·La Revue de médecine interne·Y MoussaidL Vedrine
Jul 15, 2004·Oncology Nursing Forum·Anita NirenbergElaine Larson
Jun 22, 2010·Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners·Román Pérez Velasco

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