Side effects of using granulocyte-colony stimulating factors as prophylaxis of febrile neutropenia in cancer patients: A systematic review

Crit Rev Oncol Hematol. 2021 Jan:157:103193. doi: 10.1016/j.critrevonc.2020.103193. Epub 2020 Dec 10.

Abstract

Introduction: We systematically reviewed the literature regarding short- and long-term safety and tolerability of prophylactic use of Granulocyte-Colony Stimulating Factor (G-CSF) for chemotherapy-related febrile neutropenia (FN).

Methods: 730 pertinent records published from 1994 to 2020 were identified. Exclusion criteria included no assessment of safety or Quality of life (QOL).

Results: Among 88 full-texts included, most studies were conducted during or shortly after G-CSF administration. Mild-to-moderate medullary bone pain was the most reported side effect, usually responsive to anti-inflammatory drugs although potentially impactful on daily functioning. Transient leukocytosis, thrombocytopenia and alterations in biochemistry were also commonly reported. Short-term improvements in patient-reported outcomes were observed as a result of reduction of FN and secondary complications. Secondary myeloid neoplasms were the only reported late effect. No studies evaluated the long-term impact on QOL.

Conclusions: G-CSF seem safe and well-tolerated, although few data are available on long-term impact of use of G-CSF.

Keywords: Adverse effects; Chemotherapy; Granulocyte-colony stimulating factors; Health-related quality-of-life; Patient-reported outcomes.

Publication types

  • Systematic Review

MeSH terms

  • Febrile Neutropenia* / chemically induced
  • Febrile Neutropenia* / prevention & control
  • Granulocyte Colony-Stimulating Factor / therapeutic use
  • Granulocytes
  • Humans
  • Neoplasms* / complications
  • Neoplasms* / drug therapy
  • Quality of Life

Substances

  • Granulocyte Colony-Stimulating Factor