Prophylactic administration of granulocyte colony‐stimulating factor (filgrastim) after conventional chemotherapy in children with cancer

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Abstract
We evaluated granulocyte colony‐stimulating factor (G‐CSF) as an adjunct to courses of conventional chemotherapy in 16 children with cancer. One course followed by G‐CSF (20 episodes) was compared to identical courses without G‐CSF (20 episodes) in the same patients. The mean duration of G‐CSF therapy was 8.8 (5‐13) days. The periods of neutropenia (4.8 days versus 16.5 days; p < 0.0001), days of hospitalization for febrile neutropenia (13 days versus 65 days; p = 0.02) and days on broad‐spectrum antibiotics (13 days versus 95 days; p = 0.003) were significantly reduced. With the use of G‐CSF the profound neutropenia could be prevented in 11 (55%) episodes. There were two episodes of fever and neutropenia in the G‐CSF group as compared to 10 febrile neutropenias in the control group (p = 0.04). G‐CSF was well tolerated and did not cause additional expenses when compared to the expenses needed for the treatment of febrile neutropenias. The cost benefit analyses showed that through using G‐CSF a savings was realized in the amount of U.S. $20,650 for 20 cycles of chemotherapy, i.e., U.S. $1,033/chemotherapy cycle. We conclude that the use of G‐CSF was efficacious and did not increase the total costs of therapy.

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