Granulocyte colony-stimulating factors in the management of chemotherapy-induced neutropenia: evidence based review

Key points (1) Neutropenia is a frequent complication of chemotherapy associated with life-threatening infections, hospitalisation, and chemotherapy dose reductions and delays. (2) Primary prophylaxis with granulocyte colony stimulating factors has been shown to reduce the incidence and duration of neutropenia, febrile neutropenia, infections hospitalisation and antibiotic use. (3) Recent randomised clinical trials of filgrastim, lenograstim and pegfilgrastim showed variable results across patient groups at different risks of febrile neutropenia. (4) Pegfilgrastim is at least as effective as filgrastim in the prophylaxis of chemotherapy induced neutropenia and has improved pharmacokinetics requiring reduced administration.