ASCO updates guidelines for colony-stimulating factor use

(HealthDay)—The 2006 American Society of Clinical Oncology guidelines on use of hematopoietic colony-stimulating factors (CSFs) have been updated, according to a special article published online July 13 in the Journal of Clinical Oncology.

Thomas J. Smith, M.D., from the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center in Baltimore, and colleagues conducted a systematic review of the literature and updated the 2006 American Society of Clinical Oncology guidelines on the use of hematopoietic CSFs.

According to the authors, changes to prior recommendations include the addition of tbo-filgrastim and filgrastim-sndz; in older patients with diffuse aggressive lymphoma, the recommendation regarding routine CSF use was moderated; and recommendations in favor of high-dose intensity chemotherapy in urothelial cancer and against routine dose-dense chemotherapy in lymphoma were added. Recommendations regarding CSF use in acute myeloid leukemia or myelodysplastic syndromes in adults were not addressed. Prophylactic use of CSFs is warranted to reduce the risk of febrile neutropenia when no other equally effective and safe CSF-free regimen is available. Primary prophylaxis is recommended for those at high risk of febrile neutropenia.

"ASCO guidelines are developed for implementation across health settings," the authors write. "Barriers to implementation include the need to increase awareness of the guideline recommendations among front-line practitioners and survivors of cancer and caregivers and also to provide adequate services in the face of limited resources."

Several authors disclosed financial ties to the pharmaceutical and health insurance industries.

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