Role of hematopoietic growth factors

• Granulocyte (G-CSF) and granulocyte-macrophage (GM-CSF) colony-stimulating factors can be used (but not in AML) as 1° Ppx when expected FN incidence >20% or as 2° Ppx after FN has occurred in a prior cycle (to maintain dose-intensity for curable tumors)
• CSFs ↓ rate of FN but have not been shown to affect mortality (Cochrane 2014 CD003039)