Primary and secondary prophylactic administration of granulocyte-colony stimulating factor (G-CSF) for febrile neutropenia

The Japanese guidelines for the proper use of granulocyte-colony stimulating factor (G-CSF) have been revised on the basis of the current international guidelines and latest evidence. The guidelines for primary and secondary prophylactic administration of G-CSF are clearly defined in the revised version. Primary prophylactic administration is recommended as per the incidence of febrile neutropenia (FN): it is highly recommended for patients with an FN rate > 20%, but selectively recommended for patients with an FN rate < 20%. Secondary prophylactic administration is recommended only for patients who should be maintained on a constant dose of G-CSF for curative purposes. The revised version aims to improve, not limit, the clinical use of G-CSF based on both patient- and evidence-oriented decisions in clinical practice.