Lights and shadows on the role of rhG-CSF in cancer patients during theCOVID-19 pandemicand future perspectives of research.

Angioletta Lasagna,Marta Muzzana,Paolo Pedrazzoli

doi:10.2217/imt-2021-0219

Abstract

Lights and shadows on the role of rhG-CSF in cancer patients during theCOVID-19 pandemicand future perspectives of research.

Highlights

In managing febrile neutropenia (FN), supportive care indications have driven to an expanded use of recombinant human granulocyte colony-stimulating factors to accelerate absolute neutrophil count recovery; in particular, they have recommended its use in patients with intermediate risk (10–20%) and all patients with FN antecedents without risk factors [1,2]
Filgrastim, the first rhG-CSF approved by the US FDA in 1991, has renal- and neutrophil-mediated clearance pathways, while the serum concentrations of long-acting rhG-CSF are due to the neutrophil-mediated clearance [4]
We found three case reports of agranulocytosis following COVID-19 infection responding to rhG-CSF without apparent adverse events [11,12,13]

Summary

Introduction

Since the early phase of the COVID-19 pandemic, a principal international panel of experts from European Society for Medical Oncology (ESMO) [1] and Multinational Association of Supportive Care in Cancer (MASCC) [2], have drawn up recommendations for every aspect of the management of cancer patients.In managing febrile neutropenia (FN), supportive care indications have driven to an expanded use of recombinant human granulocyte colony-stimulating factors (rhG-CSFs) to accelerate absolute neutrophil count recovery; in particular, they have recommended its use in patients with intermediate risk (10–20%) and all patients with FN antecedents without risk factors [1,2].G-CSF is a glycoprotein that stimulates granulopoiesis and leads to proliferation, maturation and mobilisation of neutrophils [3]. In managing febrile neutropenia (FN), supportive care indications have driven to an expanded use of recombinant human granulocyte colony-stimulating factors (rhG-CSFs) to accelerate absolute neutrophil count recovery; in particular, they have recommended its use in patients with intermediate risk (10–20%) and all patients with FN antecedents without risk factors [1,2]. Some authors highlighted that the rhG-CSF administration may counteract with COVID-19-related lymphocytopenia and improve the outcome of the infection in patients without cancer [9,10].

Results

Conclusion