Use of granulocyte colony-stimulating factor (G-CSF) in clinical practice in Fukuoka City area in Japan.

BACKGROUND

Granulocyte colony-stimulating factor (G-CSF) has been used in practice in Japan since 1991, but there is still a controversy how to use it properly. It is of importance to know how Japanese physicians manage neutropenic patients with G-CSF.

METHODS

The way of using G-CSF in clinical practice after chemotherapy was investigated in Fukuoka city area in Japan. Fifty physicians working at large hospitals and in charge of oncological patients participated in this study. A questionnaire regarding use of G-CSF including case studies was directly handed to each of them. All questions were made using the American Society of Clinical Oncology (ASCO) survey for use of hematopoieteic CSFs (J Clin Oncol 1996; 14: 1957) to compare the results between the 2 countries.

RESULTS

For primary prophylactic administration of G-CSF, 29% of the physicians "always" or "usually" used it to prevent neutropenia in the first cycle of chemotherapy, while 55% physicians used G-CSF as a secondary prophylaxis for the patients with experiences of neutropenia in the previous chemotherapy and at the start of the next cycle of cytotoxic agents. Once the patients developed neutropenia, G-CSF was "always" used for afebrile neutropenia by a half of the physicians, and even more physicians used it for febrile neutropenia. Nineteen out of 50 doctors had experiences of reimbursement troubles with the health insurance largely due to too-long use of G-CSF.

CONCLUSIONS

The results are generally in agreement with ASCO members' way of using CSFs, but Japanese physicians tend to use G-CSF more frequently than ASCO members in primary prophylaxis or in treatment of neutropenia.