Walton S M
Charleston Area Medical Center, USA.
W V Med J. 1998 Jan-Feb;94(1):26-8.
The hematopoietic growth factors granulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor (GM-CSF) are approved only for prophylaxis of infectious complications secondary to the use of chemotherapy, yet both are often used off-label therapeutically in conjunction with antibiotics following the onset of neutropenic fever. Several recent trials have evaluated the use of CSFs as adjuncts to antibiotic therapy for the management of patients presenting with neutropenic fever following chemotherapy administration. Statistically significant reductions in days of neutropenia by one or two days were observed in some trials but the clinical significance of these results is uncertain. Most trials demonstrated no reductions in duration of hospitalization, number of days of fever, or mortality. Given the current lack of data supporting the use of CSFs as adjuncts to antibiotic therapy in patients presenting with neutropenic fever, and given the high cost of these drugs, their use for this indication is not recommended at this time.
造血生长因子粒细胞集落刺激因子（G-CSF）和粒细胞-巨噬细胞集落刺激因子（GM-CSF）仅被批准用于预防化疗引起的感染并发症，但在中性粒细胞减少性发热发作后，两者通常都与抗生素联合用于非标签治疗。最近的几项试验评估了使用集落刺激因子作为抗生素治疗的辅助手段，以管理化疗后出现中性粒细胞减少性发热的患者。在一些试验中观察到中性粒细胞减少天数在统计学上显著减少了1天或2天，但这些结果的临床意义尚不确定。大多数试验表明住院时间、发热天数或死亡率没有减少。鉴于目前缺乏支持在中性粒细胞减少性发热患者中使用集落刺激因子作为抗生素治疗辅助手段的数据，且这些药物成本高昂，目前不建议将其用于这一适应症。
