Flexible Granulocyte Colony-Stimulating Factor Dosing in Ovarian Cancer Patients Who Receive Dose-Intense Taxol Therapy

TOTOXIC CHEMOTHERAPY regimens used in cancer therapy are often associated with substantial hematopoietic toxicity. Fever and neutropenia (F+N+) are major morbidities that result, and the patient suffers an in- creased risk of life-threatening infection and prolonged hos- pitalization. In addition, neutropenia can limit the doses of effective therapy administered. Shortening the length and severity of neutropenia can have major benefits to patients by reducing the risk of infection and perhaps by increasing the amount of chemotherapy that can be administered per unit time. The advent of recombinant DNA technology has allowed the cloning and production of a number of colony- stimulating factors for clinical use that can potentially ame- liorate much of the hematopoietic toxicity associated with cytotoxic therapy.' In humans, granulocyte colony-stimulating factor (G- CSF) stimulates the production of functional neutrophils that are protective against infection, and it is safe and effective when administered by either intravenous or subcu- taneous routes.2 G-CSF, in conjunction with anticancer chemotherapy, is effective in stimulating granulopoiesis and decreasing the frequency of episodes of F+N+.3-5 G-CSF was used as an adjuvant with methotrexate, vinblastine, doxorubicin, and cisplatin (M-VAC) chemotherapy for bladder cancer.6 In this setting, G-CSF decreased the length c