[Evidence-based management of neutropenia and fever]

Neutropenia and related fever are the most frequently observed toxicities associated with chemotherapy use. In this review, the current approaches based on various Japanese and American medical societies' guidelines in managing these toxicities are examined. First, the therapeutic and prophylactic use of G-CSF is explored. Clinical efficacy of G-CSF as exemplified by the results of a randomized comparative trial conducted based on the latest guidelines of the American as well as Japan Societies of Clinical Oncology is demonstrated. In addition, the difference in clinical efficacy of the therapeutic use of G-CSF with the presence or absence of fever is assessed. Lastly, the current approaches based on the latest guidelines of the American Society of Infectious Diseases and National Comprehensive Cancer Network (NCCN) to manage patients with febrile neutropenia are also reviewed. Specifically, infection work-ups, antibiotics selection, proper methods of usage, and follow-up methods from these guidelines are delineated. It is hoped that this report will provide readers with the most up-to-date information in managing patients with these toxicities.