Journal of Clinical Oncology, Vol 14, 2511-2520, Copyright © 1996 by American Society of Clinical Oncology

ARTICLES

Use of hematopoietic colony-stimulating factors: the American Society of Clinical Oncology survey. The Health Services Research Committee of the American Society of Clinical Oncology

CL Bennett, TJ Smith, JC Weeks, AB Bredt, J Feinglass, JH Fetting, BE Hillner, MR Somerfield and RJ Winn
Department of Veterans Affairs, Lakeside Medical Center, Chicago, IL, USA.

PURPOSE: Dissemination of use of the hematopoietic colony-stimulating factors (CSFs) is unprecedented in oncology, with almost all physicians having experience with granulocyte colony-stimulating factor (G-CSF) or granulocyte-macrophage colony-stimulating factor (GM-CSF) shortly after the drugs received Food and Drug Administration (FDA) approval in 1991. The American Society of Clinical Oncology (ASCO) Health Services Research Committee sought to assess patterns of use of CSFs before dissemination of its first-ever publication of ASCO guidelines. METHODS: A questionnaire describing clinical scenarios was mailed to American oncologists and hematologists who practice medical oncology. In each scenario, the physician was asked whether he would prefer to use a CSF to prevent or treat neutropenia. RESULTS: The response rate to the mailed survey was 49% (N = 475). Most physicians preferred to use CSFs for secondary prophylaxis in patients receiving chemotherapy at rates of 44% to 85%, rather than reduce doses. Patterns of use did not differ for palliative, curative, or adjuvant chemotherapy. While the majority of CSF patterns of care were similar to those recommended in the ASCO guidelines, more than half of the physicians chose to use CSFs in the treatment of febrile neutropenia, an area not supported in the subsequent guidelines. In general, physicians at academic medical centers and in Health Maintenance Organization (HMO) practices were more likely to prefer dose-reduction strategies over addition of CSFs, while fee-for-service physicians preferred the opposite strategies. CONCLUSION: Variations in CSF preferences for use were related to differences in clinical characteristics (history of afebrile v febrile neutropenia), drug characteristics (G-CSF or GM-CSF), and physician practice characteristics (HMO or fee-for-service setting). However, before dissemination of the guidelines, the majority of American oncologists preferred strategies that were subsequently included in the ASCO CSF guidelines. CSF guidelines would be most likely to reduce CSF use for treatment of afebrile and uncomplicated febrile neutropenia.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				J. N.H. Timmer-Bonte, E. M.M. Adang, E. Termeer, J. L. Severens, and V. C.G. Tjan-Heijnen Modeling the Cost Effectiveness of Secondary Febrile Neutropenia Prophylaxis During Standard-Dose Chemotherapy J. Clin. Oncol., January 10, 2008; 26(2): 290 - 296. [Abstract] [Full Text] [PDF]

				A. Engert, J. Franklin, H. T. Eich, C. Brillant, S. Sehlen, C. Cartoni, R. Herrmann, M. Pfreundschuh, M. Sieber, H. Tesch, et al. Two Cycles of Doxorubicin, Bleomycin, Vinblastine, and Dacarbazine Plus Extended-Field Radiotherapy Is Superior to Radiotherapy Alone in Early Favorable Hodgkin's Lymphoma: Final Results of the GHSG HD7 Trial J. Clin. Oncol., August 10, 2007; 25(23): 3495 - 3502. [Abstract] [Full Text] [PDF]

				P. Papaldo, M. Lopez, P. Marolla, E. Cortesi, M. Antimi, E. Terzoli, P. Vici, C. Barone, G. Ferretti, S. Di Cosimo, et al. Impact of Five Prophylactic Filgrastim Schedules on Hematologic Toxicity in Early Breast Cancer Patients Treated With Epirubicin and Cyclophosphamide J. Clin. Oncol., October 1, 2005; 23(28): 6908 - 6918. [Abstract] [Full Text] [PDF]

				E. C. Schneider, A. M. Epstein, J. L. Malin, K. L. Kahn, and E. J. Emanuel Developing a System to Assess the Quality of Cancer Care: ASCO's National Initiative on Cancer Care Quality J. Clin. Oncol., August 1, 2004; 22(15): 2985 - 2991. [Full Text] [PDF]

				D. G. Pfister, D. H. Johnson, C. G. Azzoli, W. Sause, T. J. Smith, S. Baker Jr, J. Olak, D. Stover, J. R. Strawn, A. T. Turrisi, et al. American Society of Clinical Oncology Treatment of Unresectable Non-Small-Cell Lung Cancer Guideline: Update 2003 J. Clin. Oncol., January 15, 2004; 22(2): 330 - 353. [Full Text] [PDF]

				A. Engert, P. Schiller, A. Josting, R. Herrmann, P. Koch, M. Sieber, F. Boissevain, M. de Wit, J. Mezger, E. Duhmke, et al. Involved-Field Radiotherapy Is Equally Effective and Less Toxic Compared With Extended-Field Radiotherapy After Four Cycles of Chemotherapy in Patients With Early-Stage Unfavorable Hodgkin's Lymphoma: Results of the HD8 Trial of the German Hodgkin's Lymphoma Study Group J. Clin. Oncol., October 1, 2003; 21(19): 3601 - 3608. [Abstract] [Full Text] [PDF]

				H. Ozer, J. O. Armitage, C. L. Bennett, J. Crawford, G. D. Demetri, P. A. Pizzo, C. A. Schiffer, T. J. Smith, G. Somlo, J. C. Wade, et al. 2000 Update of Recommendations for the Use of Hematopoietic Colony-Stimulating Factors: Evidence-Based, Clinical Practice Guidelines J. Clin. Oncol., October 20, 2000; 18(20): 3558 - 3585. [Full Text] [PDF]

				G. Swanson, K. Bergstrom, E. Stump, T. Miyahara, and E. T. Herfindal Growth Factor Usage Patterns and Outcomes in the Community Setting: Collection Through a Practice-Based Computerized Clinical Information System J. Clin. Oncol., April 1, 2000; 18(8): 1764 - 1770. [Abstract] [Full Text] [PDF]

				C. L. Bennett, J. A. Weeks, M. R. Somerfield, J. Feinglass, and T. J. Smith Use of Hematopoietic Colony-Stimulating Factors: Comparison of the 1994 and 1997 American Society of Clinical Oncology Surveys Regarding ASCO Clinical Practice Guidelines J. Clin. Oncol., November 1, 1999; 17(11): 3676 - 3681. [Abstract] [Full Text] [PDF]

				I. Debrix, C. Bouleuc, H. Liote, B. Milleron, A. Beker, C. L. Bennett, and M. R. Somerfield Impact of American Society of Clinical Oncology Guidelines for Clinical Use of Colony-Stimulating Factors J. Clin. Oncol., October 1, 1999; 17(10): 3360 - 3361. [Full Text] [PDF]

				J. A. Talcott Outpatient Management of Febrile Neutropenia: Should We Change the Standard of Care? Oncologist, December 1, 1997; 2(6): 365 - 373. [Abstract] [Full Text] [PDF]

				L. C. Hartmann, L. K. Tschetter, T. M. Habermann, L. P. Ebbert, P. S. Johnson, J. A. Mailliard, R. Levitt, V. J. Suman, T. E. Witzig, H.S. Wieand, et al. Granulocyte Colony-Stimulating Factor in Severe Chemotherapy-Induced Afebrile Neutropenia N. Engl. J. Med., June 19, 1997; 336(25): 1776 - 1780. [Abstract] [Full Text] [PDF]