Optimal use of granulocyte-colony-stimulating factor in patients with cancer who are at risk for chemotherapy-induced neutropenia.

PURPOSE/OBJECTIVES To provide an overview of the risks for and occurrence of chemotherapy-induced neutropenia in patients with cancer and its optimal prophylactic management with recombinant human granulocyte-colony-stimulating factor (G-CSF). DATA SOURCES Original research, review articles, conference presentations, and published guidelines. DATA SYNTHESIS Chemotherapy-induced neutropenia is a common serious adverse event, and the risks for it can be predicted on the basis of patient characteristics and the chemotherapy regimen. CONCLUSIONS Optimal, cost-effective prophylactic management of chemotherapy-induced neutropenia with G-CSF requires the assessment of patient factors and the myelotoxicity of the chemotherapy regimen. IMPLICATIONS FOR NURSING Neutropenia and its complications can be serious adverse events in patients who are treated with chemotherapy. Nurses should be familiar with how to identify patients who are at risk for neutropenia and its complications and should be prepared to discuss the need for first-cycle use of G-CSF with the other members of the treatment team as necessary.