Recombinant human granulocyte-macrophage colony-stimulating factor in the treatment of febrile neutropenia

A European perspective on haematopoietic growth factors in haemato-oncology: Report of an expert meeting of the EORTC

“…The studies differed with respect to patient categories and treatment pro tocols. In three studies a significant advantage in terms of neutropenic fever was observed for GM-CSF or G-CSF [118][119][120]. In none of the studies a significant difference was found in infection-related mortality between HGF and pla cebo-treated patients.…”

“…Six rando mised studies using HGFs in patients with febrile neutrope nia have been conducted (Table 3) [117][118][119][120][121][122]. The studies differed with respect to patient categories and treatment pro tocols.…”

Economic evaluation of cancer treatments

“…Four studies have been conducted in patients with febrile neutropenia (Biesma et al, 1990;Riikonen et al, 1994;Maher et al, 1994;Mayordomo et al, 1993). In three studies a significant advantage of GM -CSF or G-CSF treatment was observed (Riikonen et al, 1994;Maher et al, 1994;Mayordomo et al, 1993).…”

“…In a number of studies this policy has resulted in a fifty percent reduction of infectious complications (Crawford et al, 1991;Gerhartz et al, 1993), while in other studies no significant effect has been shown with regard to the incidence of bacteraemia, days of fever, or the hospitalisation duration (Gorin et al, 1992;Pettengell et al, 1992). A second possibility would be to apply the HGF only in the case of infection (Biesma et al, 1990;Riikonen et al, 1994;Maher et al, 1994;Mayordomo et al, 1993). This approach would reduce the number of patients exposed to a growth factor and could potentially restrict the costs of treatment.…”

“…A limited number of studies has tested this approach. Riikonen et al (1994) demonstrated in a randomised study with 58 children that the application of GM-CSF during fever and neutropenia resulted in a faster recovery of the granulocytic lineage and a shortening of the period of hospitalisation. A recent double blind study with G-CSF in febrile neutropenia demonstrated that the greatest benefit was obtained in patients with a documented infection with a neutrophil count less than O.lxlO'/I at start of G-CSF administration (Maher et al, 1994).…”