Granulocyte growth factor use in elderly patients with non-Hodgkin's lymphoma in the United States: adherence to guidelines and comparative effectiveness

Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer
Linda S EltingSharon H Giordano

Abstract

The efficacy of prophylactic granulocyte colony-stimulating factors (G-CSFs) among elderly patients with non-Hodgkin's lymphoma (NHL) receiving CHOP-based chemotherapy has been demonstrated in clinical trials, and G-CSFs are recommended in guidelines. We studied guideline adherence and the effectiveness of G-CSFs in the general population. We used inpatient and outpatient claims from nationally representative databases linked to cancer information from tumor registries. Patients (N = 5884) diagnosed with NHL between 2001 and 2007 who were older than 65 years and who received CHOP-based chemotherapy were included. Adherence to guidelines was measured as the use of G-CSFs within 7 days of the first dose of chemotherapy. The measures of effectiveness were fever, infection, and death during cycle 1 of chemotherapy and time to cycle 2. Multiple-variable models of these outcomes were developed using logistic regression, controlling for demographic, clinical, and provider factors. G-CSF use increased from 32 % in 2001 to 72 % in 2007. Patients who received G-CSFs were significantly less likely to have outpatient encounters for infection than those who did not receive early G-CSFs (35 vs 47 %; p < 0.0001). Inpatient encounters for infe...Continue Reading

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Citations

Jun 28, 2016·Current Oncology Reports·Thuy KollChristopher B Steer
May 7, 2020·Current Opinion in Oncology·Jean A KlasterskyYassine Lalami
Apr 25, 2020·Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners·Jennifer R SchenfeldPrasad L Gawade
Oct 19, 2019·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Shuling LiDavid Chandler
Jun 17, 2020·Current Opinion in Oncology·Jean A KlasterskyYassine Lalami
Aug 17, 2021·Journal of the National Comprehensive Cancer Network : JNCCN·Pamala A PawloskiBernadette Eichelberger

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