PROPHYLACTIC ADMINISTRATION OF GRANULOCYTE-COLONY-STIMULATING FACTOR (FILGRASTIM) AFTER CONVENTIONAL CHEMOTHERAPY IN CHILDREN WITH CANCER

We evaluated granulocyte colony-stimulating factor (G-CSF) as an adjun ct to courses of conventional chemotherapy in 16 children with cancer. One course followed by G-CSF (20 episodes) was compared to identical courses without G-CSF (20 episodes) in the same patients. The mean dur ation of G-CSF therapy was 8.8 (5-13) days, The periods of neutropenia (4.8 days versus 16.5 days;p < 0.0001), days of hospitalization for f ebrile neutropenia (13 days versus 65 days; p = 0.02) and days on broa d-spectrum antibiotics (13 days versus 95 days; p = 0.003) were signif icantly reduced. With the use of G-CSF the profound neutropenia could be prevented in 11 (55%) episodes, There were two episodes of fever an d neutropenia in the G-CSF group as compared to 10 febrile neutropenia s in the control group (p = 0.04). G-CSF was well tolerated and did no t cause additional expenses when compared to the expenses needed for t he treatment of febrile neutropenias, The cost benefit analyses showed that through using G-CSF a savings was realized in the amount of U.S. $20,650 for 20 cycles of chemotherapy, i.e, U.S. $1,033/chemotherapy cycle, We conclude that the use of G-CSF was efficacious and did not i ncrease the total costs of therapy.