NCCN Guidelines® Insights: Hematopoietic Growth Factors, Version 1.2022

Griffiths, Elizabeth A.; Roy, Vivek; Alwan, Laura; Bachiashvili, Kimo; Baird, John H.; Cool, Rita; Dinner, Shira; Geyer, Mark B.; Glaspy, John A.; Gojo, Ivana; Hicks, Ashley; Kallam, Avyakta; Kidwai, Wajih Zaheer; Kloth, Dwight D.; Kraut, Eric H.; Landsburg, Daniel J.; Lyman, Gary H.; Mahajan, Anjlee; Miller, Ryan; Nachar, Victoria R; Patel, Seema; Patel, Shiven B.; Perez, Lia; Poust, Adam; Riaz, Fauzia; Rosovsky, Rachel; Rugo, Hope S.; Simon, Shayna; Vasu, Sumithira; Wadleigh, Martha; Westbrook, Kelly; Westervelt, Peter; Berardi, Ryan A; Pluchino, Lenora A.

doi:10.6004/jnccn.2022.0026

Cited by 36 publications

(51 citation statements)

References 14 publications

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“…(ii) when ANC was lower than 1.0 × 10 9 /L, especially if concurrent fever was present, oral formulations for improving neutropenia, such as Diyushengbai tablet, and injectable short-acting G-CSF were potentially used, despite being against the recommendations. 1 , 7 Patients who underwent chemotherapy and had normal levels of ANC required regular monitoring of ANC. When estimating the cost of non-SN, further laboratory ANC testing should be considered.…”

Section: Methodsmentioning

confidence: 99%

“… 4 - 6 Several guidelines recommend it for the prevention and management of chemotherapy-induced neutropenia. 7 - 9 …”

Section: Introductionmentioning

confidence: 99%

“…Some chemotherapy regimens for the treatment of breast cancer, such as TE (docetaxel + epirubicin), TC (docetaxel + cyclophosphamide), and TAC (docetaxel + doxorubicin + cyclophosphamide), require primary prophylaxis with G-CSF. 1 , 7 …”

Section: Introductionmentioning

confidence: 99%

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Outcome and Cost-Effectiveness Analysis of Long-acting G-CSF as Primary Prophylaxis of Neutropenia Induced by Chemotherapy in Breast Cancer Patients, From a Retrospective Study

Wang

Zhao

et al. 2023

Cancer Control

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Purpose This retrospective analysis aimed to evaluate the clinical outcomes and cost-effectiveness of long-acting granulocyte-colony stimulating factor as primary prophylaxis of neutropenia caused by chemotherapy for breast cancer. Methods Patients with breast cancer who received long- or short-acting granulocyte-colony stimulating factor as primary prophylaxis of neutropenia were enrolled in this study, and incidences of neutropenia were compared between two groups. A decision-analytic and a Markov model were used to compare the health benefits and costs of utilizing long- vs short-acting granulocyte-colony stimulating factor as the primary prophylaxis from the perspective of the Chinese health service system. Subsequently, one-way deterministic and probabilistic sensitivity analyses were conducted. The incremental cost-effectiveness ratios were calculated in baseline and sensitivity analyses. Results Patients receiving long-acting granulocyte-colony stimulating factor as the primary prophylaxis of chemotherapy-induced neutropenia experienced a significant lower incidence of this adverse event, compared with the short-acting one for 2 to 7 days. The outcomes of baseline analysis indicated that long-acting granulocyte-colony stimulating factor had a gain of 0.08 quality-adjusted life years and costed $149 more than the short-acting one, yielding an incremental cost-effectiveness ratio of $1792 per quality-adjusted life year. The sensitivity analysis proved the stability of our models and economic efficiency of long-acting granulocyte-colony stimulating factor. Conclusions Patients receiving long-acting granulocyte-colony stimulating factor as primary prophylaxis of neutropenia experienced lower risk of this event compared with those underusing short-acting one. The long-acting granulocyte-colony stimulating factor may be a more cost-effective strategy for primary prophylaxis of neutropenia than short-acting one, considering the Chinese willingness-to-pay threshold of $12158.6 per quality-adjusted life year.

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Section: Methodsmentioning

confidence: 99%

“… 4 - 6 Several guidelines recommend it for the prevention and management of chemotherapy-induced neutropenia. 7 - 9 …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Outcome and Cost-Effectiveness Analysis of Long-acting G-CSF as Primary Prophylaxis of Neutropenia Induced by Chemotherapy in Breast Cancer Patients, From a Retrospective Study

Wang

Zhao

et al. 2023

Cancer Control

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“…1 The 2022 National Comprehensive Cancer Network (NCCN) guidelines for hematopoietic growth factors recommend prophylaxis with G-CSF in at-risk patients receiving chemotherapy, specifically in chemotherapy regimens considered high risk for FN (incidence > 20%) or intermediate risk for FN (incidence 10% to 20%) with additional patient risk factors. 2 The incidence of developing FN with at least 1 chemotherapy cycle is estimated at 10% to 50% of patients with solid tumors and > 80% of patients with hematologic malignancies. 3 The rate of major complications (eg, hypotension, acute renal, respiratory, or heart failure) in the context of FN is 25% to 30%, and mortality is reported up to 11% in this population.…”

mentioning

confidence: 99%

“…3 For filgrastim, the NCCN guidelines do not specify the total days of required injections, but state that a daily dose should be given until the postnadir absolute neutrophil count (ANC) recovers to normal or near normal levels by laboratory standards. 2 It is uncommon in clinical practice to track postnadir ANCs due to frequent laboratory monitoring. Clinical trial data suggest an average duration of 11 days of daily filgrastim injections for ANC recovery; however, realworld data exist supporting a range from 4 to 10 days with a median of 7 injections per cycle for prevention of neutropenia or FN.…”

mentioning

confidence: 99%

Outcomes in Patients With Curative Malignancies Receiving Filgrastim as Primary Prophylaxis

Furney¹

2023

Federal Practitioner

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Background: Granulocyte colony-stimulating factor (G-CSF) prophylaxis has been shown to reduce the risk and duration of chemotherapy-induced neutropenia and febrile neutropenia (FN) and is recommended for at-risk patients receiving chemotherapy. Within the South Texas Veterans Health Care System (STVHCS), daily filgrastim injections remain the preferred formulation of G-CSF for primary prophylaxis of FN. Methods: This retrospective, single-center cohort study from September 2015 to September 2020 included 59 patients who received daily filgrastim as primary prophylaxis with a curative cancer diagnosis and a chemotherapy regimen. Patients had either a high risk for FN or a chemotherapy regimen with an intermediate risk for FN and additional risk factors. The primary outcome was the incidence of neutropenia/FN leading to treatment delays. Secondary outcomes included chemotherapy dose decreases or discontinuations, hospitalizations, days of hospitalization, infections, extended duration of filgrastim, and transitions to pegfilgrastim due to neutropenia/FN. Results: Patients received a median (IQR) of 7 (5-10) doses of filgrastim for primary prophylaxis. Overall, 10 (17%) patients experienced treatment delays due to neutropenia/FN. Fifteen (25%) patients were hospitalized with a median (IQR) length of stay of 5 (4-7) days, 9 (15%) patients had documented infections, and 2 (3%) patients required a chemotherapy dose reduction. Additionally, 9 (15%) patients required an additional median (IQR) of 2 (2-5) doses of filgrastim, and 9 (15%) patients were transitioned to pegfilgrastim. Conclusions: These results suggest that additional measures such as tracking postnadir absolute neutrophil counts should be performed to ensure patients receive an appropriate number of filgrastim doses to prevent complications associated with neutropenia/FN.

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Granulopoiesis-stimulating factors to prevent adverse effects in the treatment of solid tumors

Ma,

Yao,

et al. 2024

Cochrane Database of Systematic Reviews

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NCCN Guidelines® Insights: Hematopoietic Growth Factors, Version 1.2022

Cited by 36 publications

References 14 publications

Outcome and Cost-Effectiveness Analysis of Long-acting G-CSF as Primary Prophylaxis of Neutropenia Induced by Chemotherapy in Breast Cancer Patients, From a Retrospective Study

Outcome and Cost-Effectiveness Analysis of Long-acting G-CSF as Primary Prophylaxis of Neutropenia Induced by Chemotherapy in Breast Cancer Patients, From a Retrospective Study

Outcomes in Patients With Curative Malignancies Receiving Filgrastim as Primary Prophylaxis

Granulopoiesis-stimulating factors to prevent adverse effects in the treatment of solid tumors

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