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01 February 2004

G-CSF in solid tumor chemotherapy: a tailored regimen reduces febrile neutropenia, treatment delays and direct costs

Nicolas Tsavaris, Christos Kosmas, Panagiotis Gouveris, Maria Vadiak, Antonis Dimitrakopoulos, Dimitra Karadima, Efterpi Pagouni, George Panagiotakopoulos, Evanthia Tzima, Sevasti Ispoglou, Dimitris Sakelariou, Christos Koufos

Med Sci Monit 2004; 10(2): PI24-28 :: ID: 11583

Abstract

Background:Current guidelines do not recommend G-CSF for patients with risk factors for neutropenia.Material/Methods: One-hundred patients undergoing chemotherapy were randomized to treatment with G-CSF at 5 Kg/kg for established febrile neutropenia (ANC <1000/micro l) (Group A) or G-CSF at 263 Kg/day if ANC was 1500/micro l or less on the day of the expected nadir, with the duration of treatment determined by the severity of neutropenia (Group B).
Results: The number of doses of G-CSF was similar in the two groups. There were 34 cases of febrile neutropenia in Group A, but none in Group B (p=0.0001). Hospital admission for febrile neutropenia, antibiotic use and delays in chemotherapy were all significantly more common in Group A. Total direct costs were estimated to be € 66, 646 for Group A and € 47, 119 for Group B.
Conclusions: Tailoring treatment does not increase G-CSF use, but significantly reduces febrile neutropenia and treatment delays and lowers direct costs.

Keywords: Adult, Antineoplastic Combined Chemotherapy Protocols - administration & dosage, Antineoplastic Combined Chemotherapy Protocols - economics, Drug Administration Schedule, Fever - blood, Fever - complications, Fever - drug therapy, Granulocyte Colony-Stimulating Factor - administration & dosage, Granulocyte Colony-Stimulating Factor - economics, Leukocyte Count, Neoplasms - blood, Neoplasms - complications, Neoplasms - drug therapy, Neutropenia - blood, Neutropenia - complications, Neutropenia - drug therapy, Neutrophils - cytology, Neutrophils - drug effects, Adult, Antineoplastic Combined Chemotherapy Protocols - economics, Drug Administration Schedule, Fever - drug therapy, Granulocyte Colony-Stimulating Factor - economics, Leukocyte Count, Neoplasms - drug therapy, Neutropenia - drug therapy, Neutrophils - drug effects

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