591 Granulocyte-colony stimulating factor (G-CSF) administration for chemotherapy-induced neutropenia

Abstract

Neutropenia due to cytotoxic chemotherapy causes significant morbidity and mortality. In this study G-CSF (Granulocyte colony stimulating factor) was given to 37 patients treated with intensive combined chemotherapy, who developed absolute neutropenia after 51 chemotherapy cycles were evaluated. The patients were also analysed in two groups as for solid (ifosfamide and etoposide combined regimen) and hematological (mitoxantrone—cytarabine regimen) malignancies. G-CSF was initiated following the onset of neutropenia. Solid tumor patients included total 12 patients and hematologic malignancies consisted of 9 patients. Control group was available for the leukemia group and included 31 acute myeloid leukemia patients. G-CSF was started on the first day on absolute neutropenia and was given for one hour intravenous infusion in 100 cc %5 dextrose solution at the dose of 5 μg/kg/day until absolute neutrophil count was above 1000/ml for two consecutive days. G-CSF was found to be effective for the early recovery of neutrophil count. Expected response was achieved within 14 days in 91.5% of course on median fifth (range 2–14 days) day of G-CSF treatment. Duration of neutropenia was significantly snorter in the study group. The incidence of febril episodes and documented infection rates were not found to be significantly decreased. The incidence of fungal infections was not found to be decreased as well when compared to the control group. In conclusion, administration of G-CSF patients receiving intensive combination chemotherapy at the onset of neutropenia was found to be effective in shortening the period of neutropenia but did not reduce the incidence of febrile episodes and the rate of documented infections.