Disclaimer
is pocket card is derived om recommendations in the American Society of Clinical Oncolog y
Guideline. is resource is a practice tool based on ASCO
®
practice guidelines and is not intended
to substitute for the independent professional judgment of the treating physician. Practice
guidelines do not account for individual variation among patients. is pocket card does not
purport to suggest any particular course of medical treatment. Use of the practice guidelines and
this resource are voluntary. e practice guidelines and additional information are available at
www.asco.org/guidelines/wbcg f. Copyright © 2016 by American Society of Clinical Oncolog y.
All rights reserved.
Abbreviations
AML, acute myeloid leukemia; ANC, absolute neutrophil count; CSF, colony-stimulating
factor; G-CSF, granulocyte colony-stimulating factor; GM-CSF, granulocyte macrophage
colony-stimulating factor; HIV, human immunodeficiency virus; OS, overall survival; PBPC,
peripheral-blood progenitor cell; PFS, progression-free survial; SCT, stem-cell transplantation
Source
Smith TJ, Bohlke K, Lyman GH, Carson KR, Crawford J, Cross SJ, Goldberg JM,
Khatcheressian JL, Leighl NB, Perkins CL, Somlo G, Wade JL, Wozniak AJ, Armitage JO;
American Society of Clinical Oncolog y. Recommendations for the Use of WBC Growth
Factors: American Society of Clinical Oncolog y Clinical Practice Guideline Update. J Clin
Oncol. 2015 Oct 1;33(28):3199-212.
Treatment for Pediatric Patients
➤ The use of CSFs in pediatric patients will almost always be guided
by clinical protocols. As in adults, the use of CSFs is reasonable
as primary prophylaxis for pediatric patients with a high likelihood
of febrile neutropenia. Similarly, the use of CSFs for secondary
prophylaxis or for therapy should be limited to high-risk patients.
(Strong Recommendation; EB-B-H)
➤ For pediatric indications in which dose-intense chemotherapy is
known to have a survival benefit, such as Ewing sarcoma, CSFs
should be used to enable the administration of these regimens.
(Strong Recommendation; EB-B-H)
➤ CSFs should not be used in pediatric patients with nonrelapsed acute
lymphoblastic leukemia or nonrelapsed acute myeloid leukemia who
do not have an infection. (Moderate Recommendation; IC-I)
Recommendation Grading
Type Benefit/harm Evidence Quality
Strength Of
Recommendation
EB Evidence-
based
B Benefits
outweigh harms
H High Strong
CB
Consensus-
based
H Harms outweigh
benefits
I Intermediate Moderate
IC Informal
consensus
B/H Relative balance
of benefits and
harms
L Low Weak
Ins Insufficient
