Granulocyte colony-stimulating factor as secondary prophylaxis of febrile neutropenia in the management of advanced-stage Hodgkin lymphoma treated with adriamycin, bleomycin, vinblastine and dacarbazine chemotherapy: a decision analysis.

Abstract	Current practice guidelines are unclear regarding the role of secondary prophylaxis of febrile neutropenia in advanced-stage Hodgkin lymphoma despite several small retrospective studies that demonstrate the omission of growth factors to be a safe and economic practice. We used a decision-analytic model to compare secondary prophylaxis with granulocyte colony-stimulating factor (G-CSF) to no G-CSF with the onset of severe neutropenia for a hypothetical cohort of patients with advanced-stage Hodgkin lymphoma treated with adriamycin, bleomycin, vinblastine and dacarbazine (ABVD). There was a net benefit of 0.017 years and 0.037 quality-adjusted life years for no G-CSF use in severe neutropenia. On microsimulation (10 000 trials), 96% of the simulations showed that the no G-CSF strategy is preferred to the use of G-CSF. This finding was robust across a wide range of sensitivity analyses. Our analysis suggests that G-CSF not be used as secondary prophylaxis of febrile neutropenia in advanced-stage Hodgkin lymphoma.
Authors	Joanna Graczyk, Matthew C Cheung, Rena Buckstein, Kelvin Chan
Journal	Leukemia & lymphoma (Leuk Lymphoma) Vol. 55 Issue 1 Pg. 56-62 (Jan 2014) ISSN: 1029-2403 [Electronic] United States
PMID	23597142 (Publication Type: Journal Article)
Chemical References	Bleomycin Granulocyte Colony-Stimulating Factor Vinblastine Dacarbazine Doxorubicin
Topics	Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use) Bleomycin (adverse effects, therapeutic use) Dacarbazine (adverse effects, therapeutic use) Decision Support Techniques Decision Trees Doxorubicin (adverse effects, therapeutic use) Febrile Neutropenia (chemically induced, drug therapy) Granulocyte Colony-Stimulating Factor (therapeutic use) Hodgkin Disease (complications, drug therapy, mortality, pathology) Humans Markov Chains Neoplasm Staging Premedication Quality-Adjusted Life Years Treatment Outcome Vinblastine (adverse effects, therapeutic use)

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.

Realize the full power of the drug-disease research graph!