The MASCC Neutropenia, Infection and Myelosuppression Study Group evaluates recent new concepts for the use of granulocyte colony-stimulating factors for the prevention of febrile neutropenia

Abstract

Twomajor advances in the management of febrile neutropenia (FN) associated with cancer therapy occurred during the last 30 years. First, the stratification of patients with FN, according to the risk of complications, allowed more simple and less expensive management. Second, the prophylactic use of granulocyte colony-stimulating factors (G-CSF) provided a physiological way to reduce the incidence of severe granulocytopenia. These questions have been the focus of a symposium organized by the FN/ID Study Group during the recent annual Multinational Association of Supportive Care in Cancer (MASCC) meeting in NYC. The MASCC index score (developed by the MASCC FN/ID Study Group 12 years ago [1]) predicts safely those patients with FN who have a low risk ( 65 years) should receive primary prophylaxis with G-CSF, even if the chemotherapy regimen carries a risk of FN inferior to 20 %. Nonetheless, a significant proportion (20 %) of elderly patients treated for lymphoma will still develop breakthrough FN in spite of the use of G-CSF, as reported by Chan et al. from Singapore (abstract 663) [12]. It J. Klastersky (*) Institut Jules Bordet, Centre des Tumeurs de l’Universite Libre de Bruxelles, Brussels, Belgium e-mail: jean.klastersky@scm-sprl.net