Granulocyte colony-stimulating factor in established febrile neutropenia: A randomized study of pediatric patients

Mitchell, P.L.R., Morland, B., Stevens, M.C.G., Dick, G., Easlea, D., Meyer, L.C. and Pinkerton, C.R. (1997) Granulocyte colony-stimulating factor in established febrile neutropenia: A randomized study of pediatric patients. Journal of Clinical Oncology, 15 3: 1163-1170. doi:10.1200/JCO.1997.15.3.1163

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Author Mitchell, P.L.R.
Morland, B.
Stevens, M.C.G.
Dick, G.
Easlea, D.
Meyer, L.C.
Pinkerton, C.R.
Title Granulocyte colony-stimulating factor in established febrile neutropenia: A randomized study of pediatric patients
Journal name Journal of Clinical Oncology   Check publisher's open access policy
ISSN 0732-183X
1527-7755
Publication date 1997-03-01
Year available 1997
Sub-type Article (original research)
DOI 10.1200/JCO.1997.15.3.1163
Open Access Status File (Publisher version)
Volume 15
Issue 3
Start page 1163
End page 1170
Total pages 8
Place of publication Alexandria, United States
Publisher American Society of Clinical Oncology
Language eng
Formatted abstract
PURPOSE
Infection in neutropenic patients is potentially life-threatening and carries important implications for hospital resource use. Prophylactic administration of cytokines may reduce the severity of neutropenia, but involves the treatment of all patients for the possible benefit of a minority. This study evaluates whether treatment with cytokines in the setting of established febrile neutropenia will influence outcome and be potentially more cost-effective.

PATIENTS AND METHODS
In a double-blind study, pediatric patients with fever and severe neutropenia were randomized to receive granulocyte colony-stimulating factor ([G-CSF] filgrastim; 5 microg/kg/d) or placebo, in addition to antibiotics. The study protocol required a resolution of fever and a neutrophil count > or = 0.2 x 10(9)/L for hospital discharge. Patients could be randomized for up to four independent febrile episodes. A total of 186 episodes of febrile neutropenia were investigated.

RESULTS
Patients randomized to G-CSF had a shorter hospital stay (median, 5 v 7 days; P = .04) and fewer days of antibiotic use (median, 5 v 6 days; P = .02). G-CSF-treated patients also had more rapid neutrophil recovery and higher neutrophil levels at discharge. The 2-day reduction in hospital stay reduced the median bed cost by 29% per patient admission (P = .04).

CONCLUSION
Under the clinical guidelines of our institution, the use of G-CSF in the treatment of established febrile neutropenia produced a small but significant reduction in the time that children required antibiotics and hospital admission, with possible cost savings.
Keyword Acute Lymphoblastic-Leukemia
Controlled Trial
Drug-Therapy
Solid Tumors
Double-Blind
Chemotherapy
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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