[Colony stimulating factors in chemotherapy induced neutropenic fever]

We review the randomized trials published so far comparing the use of colony-stimulating factors (both G-CSF and GM-CSF) as adjunctive care in chemotherapy-induced neutropenic fever. With this treatment a slight one day reduction in duration of neutropenia under 500 neutrophils per mm3 is observed; this effect seems to be more important in prolonged neutropenias. The number of days with fever remain unchanged. No clear benefit expressed as clinical and quality of life improvement or economical saving is proved. According to these results, and as previous recommendation about the use of colony-stimulating factors pointed out, the indications for administration of such cytokines in neutropenic fever are restrictive and its use could be acceptable only in patients with poor prognostic factors.