Hematopoietic growth factors in cancer patients with invasive fungal infections

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Hematopoietic growth factors have been used in prophylaxis and treatment of neutropenic febrile episodes. Granulocyte colony-stimulating factor (G-CSF) and granulocyte macrophage colony-stimulating factor (GM-CSF) are the most common growth factors in clinical use. Both successfully shorten the duration of neutropenia following myelosuppressive or myeloablative chemotherapy. The influence of G-CSF and GM-CSF on documented infections and mortality from infections is less obvious. There is no clear evidence that treatment with growth factors reduces the incidence of fungal infections. Since mortality is not affected, considerations of morbidity and cost effectiveness currently dominate the indication for use of growth factors. At current costs, their use is indicated in prophylaxis when the likelihood of developing neutropenic febrile episodes following chemotherapy is 40% or more.