Smith, T.J., Bohlke, K., Lyman, G.H., Carson, K.R., Crawford, J., Cross, S.J., . . . American Society of Clinical Oncology. (2015). Recommendations for the use of WBC growth factors: American Society of Clinical Oncology clinical practice guideline update. Journal of Clinical Oncology, 33, 3199–3212.
RESOURCE TYPE: Evidence-based guideline
PHASE OF CARE: Active antitumor treatment
Sixty-six publications formed the evidence base for the recommendations. Forty-one were randomized, controlled trials.
The guidelines provide general recommendations for the primary and secondary prophylactic use of CSFs in patients being treated for cancer, and also outlines concerns regarding cost and the potential overuse of CSFs. The determination of a 20% risk for febrile neutropenia was not straightforward given patient variation and regimen alterations according to individual patient responses. Further work is needed to develop and evaluate clear individualized risk-based models for CSF use in a variety of patients with cancer.