HEMATOPOIETIC GROWTH-FACTORS IN CANCER-PATIENTS WITH INVASIVE FUNGAL-INFECTIONS

Hematopoietic growth factors have been used in prophylaxis and treatme nt of neutropenic febrile episodes. Granulocyte colony-stimulating fac tor (G-CSF) and granulocyte macrophage colony-stimulating factor (GM-C SF) are the most common growth factors in clinical use. Both successfu lly shorten the duration of neutropenia following myelosuppressive or myeloablative chemotherapy. The influence of G-CSF and GM-CSF on docum ented infections and mortality from infections is less obvious. There is no clear evidence that treatment with growth factors reduces the in cidence of fungal infections. Since mortality is not affected, conside rations of morbidity and cost effectiveness currently dominate the ind ication for use of growth factors. At current costs, their use is indi cated in prophylaxis when the likelihood of developing neutropenic feb rile episodes following chemotherapy is 40% or more.