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In Vitro Differentiation of Mouse Granulocyte-macrophage-colony-stimulating Factor GM-CSF-producing T Helper THGM Cells
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Early versus delayed administration of granulocyte-colony stimulating factor following chemotherapy in pediatric

Deema Al-Momani1, Wiam Al-Qasem1, Rawan Kasht1

  • 1Department of Pharmacy, King Hussein Cancer Center, Amman, Jordan.

Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners
|May 2, 2019
PubMed

Insights

Initiating granulocyte-colony stimulating factor (G-CSF) on day 3 post-chemotherapy, compared to day 1, did not increase febrile neutropenia hospitalizations in pediatric Ewing sarcoma patients. Delaying G-CSF reduced chemotherapy interruptions.

Area of Science:

  • Pediatric Oncology
  • Hematology
  • Pharmacology

Background:

  • Optimal timing for granulocyte-colony stimulating factor (G-CSF) initiation post-chemotherapy in pediatric patients remains undefined.
  • Ewing sarcoma treatment involves chemotherapy, necessitating management of neutropenia.
  • G-CSF is crucial for mitigating chemotherapy-induced neutropenia.

Purpose of the Study:

  • To compare the safety and efficacy of initiating G-CSF on day 1 versus day 3 post-chemotherapy.
  • To evaluate the impact of G-CSF timing on febrile neutropenia and chemotherapy delays in pediatric Ewing sarcoma patients.

Main Methods:

  • Retrospective study of pediatric patients with Ewing sarcoma receiving G-CSF.
  • Comparison of outcomes before (day 1 initiation) and after (day 3 initiation) a protocol change.
  • Key outcomes assessed: febrile neutropenia requiring hospitalization, hospital stay duration, and chemotherapy delay.

Main Results:

  • No significant difference in febrile neutropenia hospitalizations or length of stay between day 1 and day 3 G-CSF initiation.
  • Significantly fewer chemotherapy delays occurred when G-CSF was initiated on day 3 compared to day 1.
  • 250 cycles with day 1 G-CSF and 221 cycles with day 3 G-CSF were analyzed.

Conclusions:

  • Initiating G-CSF on day 3 post-chemotherapy is comparable to day 1 for preventing febrile neutropenia hospitalizations in pediatric Ewing sarcoma.
  • Delayed G-CSF initiation (day 3) effectively reduces chemotherapy delays due to neutropenia.
  • Further research with larger cohorts is needed to confirm the long-term impact of delayed G-CSF initiation.
Abstract

Keywords:
Delayed administrationSarcoma ewingearly administrationgranulocyte colony-stimulating factorpediatrics

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