Background The hematopoietic growth factors are a fundamental tool for medical oncologists in the treatment of chemotherapy-induced cytopenia. The proper use of these therapeutic aids plays an important role in terms of reduction of morbidity, mortality and costs.
Purpose To evaluate whether clinical practise follows national guidelines on colony stimulating factors (CSF-G) in the management of hematopoietic toxicity in oncology (AIOM 2010); to investigate the incidence of certain parameters involved in the overall assessment of the risk factors for febrile neutropenia (FN).
Materials and Methods In the first half of 2012, we analysed the CSF-G requirements in patients undergoing cancer chemotherapy. We selected patients treated with cancer chemotherapy, older than 60 years with a risk factor of FN > 20%, calculated on factors related to the chemotherapy regimen, patient age and type of tumour.
Results We identified 57 patients treated with chemotherapy and CSF-G. Of these, 27 were treated with lenograstim, 24 with pegfilgrastim and 6 with filgrastim. Evaluating the appropriateness of prescribing, according to the parameters identified, showed that only in 12 patients undergoing chemotherapy was a risk factor of FN greater than 20% observed; of these, 4 were treated with pegfilgrastim, 3 with lenograstim and 5 were not treated (3 of which were older than 65 years). We observed that most patients were treated for ovarian, breast or lung cancer or non-Hodgkin’s lymphoma, whereas only a small percentage were treated for other cancers such as endometrial, colon, bladder, thymus or biliary tract cancer.
Conclusions The comparison between clinical practise and the AIOM guidelines showed that the use of CSF-G is higher than the level required by the guidelines, when referring exclusively to the 3 major risk factors considered. Therefore, the use of CSF-G in chemotherapy regimens with a low score for febrile neutropenia seems very influenced by additional factors related to the treatment, the patient and the disease.
No conflict of interest.
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