Like other medications, CSFs have both risks and benefits. Treatment with CSFs can lower the risk that a patient will be hospitalized because of febrile neutropenia, but CSFs also cause aches in the bones, low-grade fever, malaise (feeling unwell), and involve multiple shots to deliver the medication. Your doctor can help determine your need for a CSF based on your risk of developing febrile neutropenia. This risk depends on the cancer diagnosis, cancer treatment you receive (such as dose and schedule of chemotherapy), and your medical history, age, and overall health.

The general recommendations for the use of CSFs include the following:

• The first option should be to find an effective chemotherapy schedule that doesn't require the use of CSFs, if possible.
• Patients should receive CSFs when the risk of developing febrile neutropenia is about 20% or greater, based on the patient's cancer type, treatment plan, age, medical history, and other factors. Some of these situations include:
  
  • Patients receiving dose dense chemotherapy (treatment given more often, such as every two weeks instead of every three weeks)
  • Patients older than 65 with lymphoma who are being treated with curative chemotherapy
  • Patients with health conditions that place them at higher risk of developing complications from neutropenia

There are circumstances where treatment with a CSF is not recommended [1]. Please talk with your doctor for more information. Some of these situations include:

• Patients receiving chemotherapy and radiation therapy at the same time
• Patients with neutropenia and no fever
• Patients receiving chemotherapy with a risk of febrile neutropenia that is less than 20%, which includes most chemotherapy regimens