National Comprehensive Cancer Network. (2012). NCCN Clinical Practice Guidelines in Oncology: Myeloid growth factors [v.1.2012].

DOI Link

http://www.nccn.org/professionals/physician_gls/f_guidelines.asp#site

Purpose & Patient Population

The purpose of this article is to provide guidance regarding the use of myeloid growth factors for adult patients with cancer. The study focused on chemotherapy-induced neutropenia.

Type of Resource/Evidence-Based Process

Consensus-based guideline

Phase of Care and Clinical Applications

There were multiple phases of care
Applicatin was for palliative care

Results Provided in the Reference

Not applicable or stated

Guidelines & Recommendations

Recommends prophylactic use of colony-stimulating factors (CSFs) in patients with 20% risk of febrile neutropenia, consideration of CSFs with 10%–20% risk, and no CSF for less than 10% risk.

Suggests consideration of secondary prophylaxis in cases of prior febrile neutropenia or dose-limiting neutropenic event.

Recommends continuation of CSFs during chemotherapy cycle in the setting of febrile neutropenia for those on prophylactic CSF, and consideration of initiating CSFs in patients with risk factors for infection-associated complication.

Provides extensive listing of factors indicating, 20%, 10%–20% risks. Provides information on toxicity risks with growth factors as well as dose and timing recommendations.

Limitations

Most recommendations are based on low level of evidence and consensus.

Nursing Implications

Provides expert opinion and consensus-based recommendations regarding the use of CSFs in patients undergoing chemotherapy for cancer.