Munoz Langa, J., Gascon, P., de Castro, J., & the Spanish Society of Clinical Oncology. (2012). SEOM clinical guidelines for myeloid growth factors. Clinical and Translational Oncology, 14, 491–498.

The purpose of the study was to facilitate practice based on clinical evidence by establishing practice guidelines on the use of myeloid growth factors. Adults in hematology and oncology were studied.
 

The resource type was evidence-based guideline. The process of development included a review of the meta-analysis, systematic Cochrane review, and a review of several randomized clinical trials.

The Cochrane database was reviewed. Keywords included  neutropenia, febrile neutropenia, myeloid growth factors, G-CSF, clinical practice guidelines, filgrastim, and pegfilgrastim
 

Active antitumor treatment

This article did not discuss the specific evidence, but outlined benefits of treatment with colony-stimulating factor (CSF) and its use in chemotherapy regimens. Distinguished use as secondary or therapeutic and reviewed the different types of CSFs to be used with which tumor types. The volume of citations was 35.

The use of CSF for primary prophylaxis should be based on the risk of an episode of febrile neutropenia based on disease and chemotherapy regimen. Chemotherapy regimens with risk of febrile neutropenia greater than 20% of primary prophylaxis with CSF is recommended; 10%–20% febrile neutropenia CSF should be considered and less than 10% risk CSF is not recommended. Secondary prophylaxis following an episode of febrile neutropenia or dose-limiting neutropenia, CSF should be considered if not given previously or in cases in which a reduction or delay of the dose is associated with poor prognosis.  Therapeutic use when patients present with febrile neutropenia is recommended based on the existing risk factors for poor clinical outcomes or for developing infection-associated complications.

Risk factors are older than age 65 years, sepsis syndrome, severe neutropenia, absolute neutrophil count (ANC) less than 100 mcl or prolonged duration of more than 10 days, pneumonia, invasive fungal infection or other clinically documented infections, hospitalization at time of fever, and prior episode of febrile neutropenia.

Provides professional evidence-based guidelines for use of CSFs for prophylaxis and treatment of febrile neutropenia. Recommendations here are consistent with those of past versions, and are consistent with those of the National Comprehensive Cancer Network and other relevant professional groups.