Researchers from Canada have reported that the use of prophylactic hematopoietic colony-stimulating factors (CSFs) decrease febrile neutropenia and infection but have no impact on survival. The details of this meta-analysis were reported in the September 18, 2007 issue of the Annals of Internal Medicine.
The administration of prophylactic Neupogen® (filgrastim) or Neulasta® (pegfilgrastim) to patients receiving chemotherapy accelerates neutrophil recovery, decreases the incidence of febrile neutropenia, decreases infectious episodes and improves delivery of protocol doses of chemotherapy. In most studies, the prophylactic administration of Neupogen or Neulasta following chemotherapy does not improve survival. However, in a recent study from the University of Rochester, the University of Washington and Duke University, the prophylactic use of Neupogen reduced febrile neutropenia and early deaths due to infections in adult patients receiving chemotherapy (see first item of related news).
The authors of the current study performed meta-analyses on data from 148 published randomized trials that compared a prophylactic CSF to nothing or a placebo in patients with caner receiving chemotherapy or a stem cell transplant.
| CSF Group | Control Group |
Short-Term Mortality | 7.5% | 8% |
Infectious Mortality | 3.1% | 3.8% |
Documented Infections | 38.8% | 43.1% |
Microbiologically Documented Infections | 23.5% | 28.6% |
Episodes of Febrile Neutropenia | 25.3% | 44.2% |
These authors concluded that prophylactic CSF use had little or no effect on survival but is associated with a decreased rate of infection.
Comments: These data confirm other observations about the use of prophylactic CSFs in cancer patients.
Reference: Sung L, Nathan PC, Alibhai AMH, et al. Meta-analysis: Effect of prophylactic hematopoetic colonly-stimulating factors on mortality and outcomes of infection. Annals of Internal Medicine. 2007;147:400-411.
Related News:
Prophylactic G-CSF Reduces Febrile Neutropenia and Early Infectious Deaths (7/24/2007)
Neulasta® Decreases Neutropenia in Patients with Colorectal Cancer Receiving Every 2 Week Chemotherapy (8/8/2007)
ASCO Guidelines for Use of White Blood Cell Growth Factors Published (7/19/2006)
Low Incidence of Neutropenic Complications Among Patients Treated with Neulasta® in Community Setting (6/6/2006)
Neulasta® and Aranesp® Provide Effective Hematopoietic Support for Dose-Dense Chemotherapy (11/21/2005)
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