Review of special populations for the use of colony-stimulating factors

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6154 Background: Identifying predisposing factors of febrile neutropenia (FN) may help to improve quality of cancer care by identifying appropriate CSF patients. Many studies have identified different risk factors that increase the likelihood of FN or related complications. A systematic literature review was conducted to evaluate the body of evidence. Methods: MEDLINE databases were searched for English-language articles published between 01/87–02/03 containing the search terms chemotherapy, neutropenia, risk factors, and epidemiologic factors, among others. Two reviewers conducted the review and interrater reliability was calculated. Results: MEDLINE search yielded 932 articles. Following title and abstract review, 133 were selected for full-text review. 24 studies assessing risk factors for FN and related complications in lymphoma and solid tumor patients met the inclusion criteria. Interrater reliability at each phase exceeded 0.70. Eight studies assessed FN predictors; 10 evaluated neutropenia predictors; and 4 studied FN-related hospitalizations. Age, performance status, bone marrow involvement, and myelosuppressive chemotherapy were the most frequently assessed predictors. Age (>70 years [24%] vs <70 years [7%], P<0.001) and receipt of myelosuppressive chemotherapy (OR ranged from 2.69 to 14.4 in studies reporting multivariate results) consistently significantly increased FN risk. Other factors such as performance status [3 of 8 studies; multivariate OR = 7.2 (95% CI: 2–22) for solid tumor patients and 18.8 (95% CI: 3.71–95) for lymphoma patients] and bone marrow involvement (1 out of 6 studies) were statistically significant in some studies but not others. Conclusions: This review suggests that older patients, patients undergoing myelosuppressive chemotherapy, and those with low performance status were at increased FN risk and may benefit from first-cycle CSF administration. Commonly recognized risk factors such as prior chemotherapy, tumor stage/type, prior FN history, and low hemoglobin levels were associated with FN in only some of the studies reviewed. Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Amgen, Inc. Amgen, Inc. Amgen, Inc.