Document Detail


Prophylactic colony-stimulating factors in children receiving myelosuppressive chemotherapy: a meta-analysis of randomized controlled trials.
MedLine Citation:
PMID:  16678350     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The colony-stimulating factors (CSFs) are widely utilized to prevent neutropenic complications in both adults and children, but randomized controlled trials in the pediatric setting have reported varied results. A systematic review of the literature and meta-analysis were conducted to definitively assess the impact of prophylactic CSFs on the risk of febrile neutropenia (FN) in pediatric oncology patients. METHODS: MEDLINE was searched and references hand-searched through July 2004 for randomized controlled trials of prophylactic G-CSF or GM-CSF in pediatric oncology patients. Objectives, outcomes, and quality of the 16 included studies were extracted by two reviewers. Weighted summary estimates of relative risks (RR) were calculated for FN and documented infection (DI). Mean differences in hospitalization, antibiotic use, and duration of neutropenia were calculated. RESULTS: FN occurred in 68% of 400 controls and 59% of 404 CSF patients. The estimated RR was 0.88 [0.81-0.97; (P=0.01)] favoring the CSFs for leukemia and high grade lymphoma studies and 0.71 [0.51-0.97; (P=0.03)] for solid tumor studies. DI occurred in 25% of controls and 20% of CSF patients for an estimated RR of 0.80 [0.61-1.06; (P=0.12)]. The mean decrease in duration of neutropenia was 3.5 days [2.2-4.7; (P<0.0001)]. Mean decreases favoring CSF use were also observed for hospital stay of 1.7 days [0.9-2.5 (P<0.01)] and antibiotic use of 2.0 days [0.4-3.6; P=0.02]. CONCLUSIONS: Prophylactic CSFs significantly decrease the incidence of FN and the durations of severe neutropenia, hospitalization, and antibiotic use in pediatric cancer patients, but they do not significantly decrease documented infections.
Authors:
Brenda Wittman; John Horan; Gary H Lyman
Publication Detail:
Type:  Journal Article; Meta-Analysis; Review     Date:  2006-05-05
Journal Detail:
Title:  Cancer treatment reviews     Volume:  32     ISSN:  0305-7372     ISO Abbreviation:  Cancer Treat. Rev.     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-06-07     Completed Date:  2006-08-11     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7502030     Medline TA:  Cancer Treat Rev     Country:  England    
Other Details:
Languages:  eng     Pagination:  289-303     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA.
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MeSH Terms
Descriptor/Qualifier:
Anti-Bacterial Agents / therapeutic use
Antineoplastic Agents / adverse effects,  therapeutic use*
Bone Marrow / drug effects*
Chemoprevention
Child
Colony-Stimulating Factors / therapeutic use*
Granulocyte Colony-Stimulating Factor / therapeutic use
Granulocyte-Macrophage Colony-Stimulating Factor / therapeutic use
Hospitalization
Humans
Neutropenia / prevention & control*
Randomized Controlled Trials as Topic
Risk Factors
Time Factors
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Antineoplastic Agents; 0/Colony-Stimulating Factors; 143011-72-7/Granulocyte Colony-Stimulating Factor; 83869-56-1/Granulocyte-Macrophage Colony-Stimulating Factor

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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