Effect of granulocyte-colony stimulating factor on empiric therapy with flomoxef sodium and tobramycin in febrile neutropenic patients with hematological malignancies
M. Yoshida et al., Effect of granulocyte-colony stimulating factor on empiric therapy with flomoxef sodium and tobramycin in febrile neutropenic patients with hematological malignancies, INT J HEMAT, 69(2), 1999, pp. 81-88
The clinical effects of concomitant use of granulocyte-colony stimulating f
actor (G-CSF) on empiric antibiotic therapy in febrile neutropenic patients
were evaluated in a randomized fashion. Two hundred and fourteen neutropen
ic febrile episodes (neutrophil counts <1.0 x 10(9)/l) were treated with fl
omoxef sodium and tobramycin with or without G-CSF. The resolution of fever
at day 4 (excellent response) or at day 7 (good response) was deemed effec
tive. Among 157 evaluable episodes, the observed excellent responses were 3
1 (38.8%) and the good responses were 20 (25.0%) in the G-CSF group; those
in the control group were 26 (33.8%) and 25 (32.5%), respectively. The over
all efficacy rate was 63.8% (51/80) in the G-CSF group and 66.2% (51/77) in
the control group (not significant). The initial neutrophil count was 0.18
6 +/- 0.249 x 10(9)/l in the G-CSF group and 0.235 +/- 0.290 x 10(9)/l in t
he control group, and rose to 2.889 +/- 4.198 x 10(9)/l and 0.522 +/- 0.844
x 10(9)/l, respectively, at day 7. These results indicate that G-CSF does
not affect the rate of response to empiric antibiotic therapy in febrile ne
utropenic patients, although a significant effect of G-CSF was observed on
neutrophil recovery. (C) 1999 The Japanese Society of Hematology.