Real-World Conundrums and Biases in the Use of White Cell Growth Factors

Thomas J. Smith, Bruce E. Hillner

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


We present the 2015 American Society of Clinical Oncology (ASCO) white cell growth factors, or colony-stimulating factor (CSF), guidelines, updated from 2006. One new indication has been added-dose-intense chemotherapy for bladder cancer-to accompany the existing use for dose-dense breast cancer chemotherapy. Colony-stimulating factors remain appropriate for any regimen where the risk of febrile neutropenia is about 20% per cycle and dose reduction is not appropriate. Based on new evidence from multiple trials, CSF use is no longer indicated in treatment of lymphoma unless there are special risk factors. The United States accounts for 78% of the sales of CSF. The panel approved the use of all biosimilars, but the cost savings will be small as the price is about 80% of the branded CSFs. More biosimilars at lower cost are awaited. Methods to reduce use without harm to patients, by requiring justification according to accepted guidelines, are ongoing.

Original languageEnglish (US)
Pages (from-to)e524-e527
JournalAmerican Society of Clinical Oncology educational book. American Society of Clinical Oncology. Meeting
StatePublished - 2016
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)


Dive into the research topics of 'Real-World Conundrums and Biases in the Use of White Cell Growth Factors'. Together they form a unique fingerprint.

Cite this