A Retrospective Evaluation of Low-Dose rhG-CSF in Chemotherapy-Induced Neutropenia

ABSTRACT Recombinant human granulocyte colony stimulating factor (rhG-CSF) 5μg/kg/day has been useful in reducing neutropenic sequelae of chemotherapy. In this study, the effect of a low dose regimen of rhG-CSF (1.5 to 3.0μg/kg/day) is evaluated. Charts of all patients who received low-dose rhG-CSF at the Saskatoon Cancer Centre and Allan Blair Cancer Centre between April 1992 and April 1993 were reviewed retrospectively. Patients must have had completed at least two consecutive cycles of chemotherapy. Patients were used as their own controls. Ten patients received rhG-CSF during the study period, six were evaluable. Endpoints which showed significant improvement with rhG-CSF included the duration of neutropenia, use of oral antibiotics required for prophylaxis, and chemotherapy treatment delays (two-tailed, paired t-test, p≤0.05). Significant differences were not found for the other endpoints, degree of neutropenia, hospital stay for neutropenia, IV antibiotic use, and occurrence of chemotherapy dosage reductions or increases. RhG-CSF utilized at this low dose may prevent sequelae of chemotherapy-induced neutropenia at a manageable cost. RESUME L'administration de la forme recombinante de stimulateurs des facteurs dc croissance granulocytomonocylaires (rhG-CSF), a raison de 5 μg/kg/j, s'est averee utile pour attenuer les sequelles liees a la neutropenie d'origine chimiotherapeutique. Cette etude evalue l'effet du rhG-CSF administre a faible dose (1,5 a 3,0 μg/kg/j). On a analyse retrospectivement les fiches de tous les patients qui ont recu du rhG-CSF a faible dose au Saskatoon Cancer Centre et au Allan Blair Cancer Centre entre avril 1992 et avril 1993. Les patients devaient avoir termine au moins deux cycles consecutifs de chimiotherapie. Les patients etaient leurs propres temoins. Dix patients ont recu le rhG-CSF au cours de la periode d'etude et six etaient evaluables. Les parametres etudies qui montrent des ameliorations notables avec l'administration du rhG-CSF comprennent la duree de la neutropenie, l'utilisation d'antibiotiques oraux necessaires en prophylaxie, et les reports de traitement chimiotherapeutique (test de t apparie bilateral, p ≤ 0,05). Aucune difference significative n'a ete observee pour les autres parametres; intensite de la neutropenie, duree de l'hospitalisation pour traiter la neutropenie, utilisation des antibiotiques i.v., et occasions de reductions ou d'augmentations des doses d'agents chimiotherapeutiques. Le rhG-CSF utilise a faible dose pourrait prevenir les sequelles liees a la neutropenie d'origine chimiotherapeutique e des couts raisonnables.