Personalized medicine and cancer supportive care: appropriate use of colony-stimulating factor support of chemotherapy.

Myelosuppression and neutropenic complications remain major dose-limiting toxicities of cancer chemotherapy resulting in increased morbidity, mortality, and costs ( 1 , 2 ). The major factors that are associated with the risk of mortality from febrile neutropenia (FN) include older age, cancer type and stage, documented infection, bacteremia, sepsis, venous thromboembolism, and the number of serious comorbid conditions ( 2 – 6 ). The risk for neutropenic complications, including FN, is greatest during the first cycle of chemotherapy when most patients are still receiving the full dose and schedule ( 7 , 8 ). When subsequent full-dose chemotherapy is continued on schedule without colony-stimulating factor (CSF) prophylaxis despite a previous neutropenic event, the risk of FN Personalized Medicine and Cancer Supportive Care: Appropriate Use of Colony-Stimulating Factor Support of Chemotherapy