ASCO Patient Guide: White Blood Cell Growth Factors

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ASCO Patient Guide: White Blood Cell Growth Factors

Introduction

Special Announcement on Leukine (sargramostim) (Updated January 25, 2008): Patients and doctors need to be aware that there has been a voluntary market suspension of the current liquid formulation of this drug because of an upward trend in spontaneous reports of adverse reactions, including syncope (fainting). The lyophilized (freeze-dried) form of the drug is not affected. See the U.S. Food and Drug Administration (FDA) website (http://www.fda.gov/medwatch/safety/2008/safety08.htm#Leukine) for more information.

To help doctors give their patients the best possible care, ASCO asks its medical experts to develop recommendations for specific areas of cancer care. ASCO recently updated a clinical practice guideline about the use of white blood cell growth factors. This patient guide is based on ASCO's recommendations.

As you read this guide, please keep in mind that every person treated for cancer is different. These recommendations are not meant to replace your or your doctors' judgment. The final decisions you and your doctors make will be based on your individual circumstances.

Information in ASCO's patient education materials is not intended as medical advice or as a substitute for the treating doctor's own professional judgment; nor does it imply ASCO endorsement of any product or company.

Last Updated: February 12, 2008

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Recommendations

Like other medications, CSFs have both risks and benefits. Treatment with CSFs can lower the risk that a patient will be hospitalized because of febrile neutropenia, but CSFs also cause aches in the bones, low-grade fever, malaise (feeling unwell), and involve multiple shots to deliver the medication. Your doctor can help determine your need for a CSF based on your risk of developing febrile neutropenia. This risk depends on the cancer diagnosis, cancer treatment you receive (such as dose and schedule of chemotherapy), and your medical history, age, and overall health.

The general recommendations for the use of CSFs include the following:

The first option should be to find an effective chemotherapy regimen that doesn't require the use of CSFs, if possible.

Patients should receive CSFs when the risk of developing febrile neutropenia is about 20% or greater, based on the patient's cancer type, treatment plan, age, medical history, and other factors. Some of these situations include:
- Patients receiving dose dense chemotherapy (treatment given more often, such as every two weeks instead of every three weeks)
- Patients older than 65 with lymphoma who are being treated with curative chemotherapy
- Patients with health conditions that place them at higher risk of developing complications from neutropenia

There are circumstances where treatment with a CSF is not recommended. Please talk with your doctor for more information. Some of these situations include:

Patients receiving chemotherapy and radiation therapy at the same time

Patients with neutropenia and no fever

Patients receiving chemotherapy with a risk of febrile neutropenia that is less than 20%, which includes most chemotherapy regimens.

Last Updated: February 12, 2008

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