Granulocyte colony-stimulating factors (G-CSFs) were effective in preventing outpatient encounters for fever and infection in elderly patients with non-Hodgkin lymphoma, but not inpatient encounters or deaths during cycle 1, according to a study published online ahead of print in the journal Supportive Care in Cancer.1

Clinical trials have demonstrated the efficacy of prophylactic G-CSF among elderly patients with non-Hodgkin lymphoma receiving CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone)-based chemotherapy, and G-CSFs are recommended in cancer treatment guidelines.

Therefore, researchers at the University of Texas MD Anderson Cancer Center in Houston, Texas, sought to evaluate guideline adherence and the effectiveness of G-CSFs in the general US population.

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For the study, investigators analyzed data from inpatient and outpatient claims belonging to 5884 patients with non-Hodgkin lymphoma diagnosed between 2001 and 2007 who were older than 65 years and received CHOP-based chemotherapy.

Results showed that G-CSF use within 7 days of the first dose of chemotherapy increased from 32% in 2001 to 72% in 2007.

Researchers found that patients who received G-CSFs were significantly less likely to have outpatient encounters for infection compared with those who did not receive early G-CSFs (P<.0001).

In contrast, there was no statistically significant difference in inpatient encounters for infections between those who did and those who did not receive early G-CSFs (P=.2). The study also demonstrated no association between G-CSF use and mortality during cycle 1 of chemotherapy.


1. Elting LS, Xu Y, Chavez-MacGregor M, Giordano SH. Granulocyte growth factor use in elderly patients with non-Hodgkin’s lymphoma in the United States: adherence to guidelines and comparative effectiveness [published online ahead of print January 21, 2016]. Supp Care Cancer. doi:10.1007/s00520-016-3079-4.