Prophylactic G-CSF and GM-CSF Decrease Febrile Neutropenia Following Chemotherapy in Children with Cancer: A Meta-Analysis of Randomized Controlled Trials. Session Type: Oral Session

Lillian Sung, Paul C. Nathan, Beverly Lange, Joseph Beyene, George Buchanan (Intr. by Angela Punnett)

Author address: 

Division of Hematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada; Pediatric Branch, National Cancer Institute, Bethesda, MD, USA; Division of Oncology, Childrens Hospital of Philadelphia, Philadelphia, PA, USA; Population Health Scien

Abstract: 

Background: The role of hematopoietic colony stimulating factors (CSFs) in children with cancer is unclear. Our primary objective was to determine whether prophylactic CSF reduces the rate of febrile neutropenia in children with cancer. Our secondary objectives were to determine whether prophylactic CSF reduces the duration of hospitalization, rate of documented infections, duration of parenteral antibiotics, amphotericin B use, or infection-related morality. Data Sources: Medline (1966 to July 2003) and EMBASE (1980 to July 2003) searches were supplemented with a hand search of references and major conferences, and contact with the pharmaceutical manufacturers of CSFs. Study Selection: Studies were included if the study population consisted of children, or if data was extractable for those 18 years of age, if there was a randomization between CSF and placebo/no therapy, if CSF was administered in the prophylactic setting (before the onset of neutropenia or febrile neutropenia), and if the chemotherapy preceding CSF was identical to that preceding placebo/no therapy. From the 971 reviewed articles, 16 studies were included. Data Extraction: Two investigators independently extracted data on study characteristics, validity and primary and secondary outcomes. Data Synthesis: The mean rate of febrile neutropenia in the control arms was 57% (range 39 to 100%). Using a random effects model, CSF use was associated with a reduction in febrile neutropenia, with a rate ratio of 0.80 (95% CI 0.67, 0.95; p=0.01), and a decrease in the length of hospitalization, with a weighted mean difference of 1.9 (95% CI 2.7, -1.1) days; p
2003

abstract No: 

882

Full conference title: 

American Society of Hematology 45th Annual Meeting
    • ASH 45th (2003)