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The majority of patient characteristics were similar between the 2 groups, as was the percentage of patients with poor prognostic risk factors. About half of the patients had received G-CSF prophylactically in this study,�� says Jeffrey Crawford, MD, codirector of the Solid Tumor Therapeutics program at the Duke Cancer Institute in Durham, North Carolina. ��It would be important to know how many had received pegfilgrastim. There would likely be no benefit to further adjunctive G-CSF, as therapeutic serum concentrations of pegfilgrastim should already be present in these patients. In the United States, the majority of patients getting prophylactic growth factor receive pegfilgrastim. At the time of presentation, patients treated with adjunctive G-CSF were found to have a significantly lower absolute http://www.selleckchem.com/products/XL184.html neutrophil count (ANC) nadir than those who did not receive therapeutic G-CSF. However, the Multinational Association of Supportive Care in Cancer (MASCC) score was not found to be statistically significantly different between groups, the http://www.selleck.cn/products/MLN8237.html authors note. The MASCC score is a validated risk index incorporating multiple factors to identify a patient's risk of complications from FN (J Clin Oncol. 2000;18:3038-3051). In the current study, the majority of patients (81%) were considered to be low risk based on MASCC scoring. Complications from FN, specifically duration of grade 4 neutropenia (ANC? http://www.selleckchem.com/products/CP-690550.html can be drawn are limited,�� says Dr. Crawford. ��Most randomized studies investigating therapeutic G-CSF do show a modest decrease in time to ANC recovery, as well as fewer days of hospitalization, but a mortality benefit has not been established in these randomized trials. The presence of an invasive fungal infection and a low ANC nadir were found to be significant predictors of poor outcomes. Patients with invasive fungal infections were 4 times more likely to have a prolonged hospitalization, and a 1-unit (1 �� 109/L) decrease in the ANC nadir conferred a 12.5-fold increase in the risk of prolonged hospitalization.