Hematopoietic growth factors: ESMO Recommendations for the applications

Abstract

Despite relatively high rates of low neutrophil counts during standard dose chemotherapy regimens for malignancies other than acute leukemias, rates of FN, other complication rates and mortality rates are relatively low for most standard chemotherapies (Table 1). These rates do not justify the systematic use of hematopoietic growth factors (hGFs) such as granulocyte colony-stimulating factor (G-CSF) or its pegylated form (pegfilgrastim) in prophylaxis of chemotherapy-induced neutropenia unless the risk of FN exceeds 20%, or there are special circumstances as outlined below. Colony-stimulating growth factors should be avoided in patients who are not at high risk for FN or neutropenic complications. The use of hGFs for treatment of FN is also not recommended, except in settings with increased morbidity and mortality, including sepsis, tissue infection and prolonged neutropenia. These agents should be particularly avoided in patients with infections not related to neutropenia, such as communityor hospital-acquired pneumonia [I, A].