Adult Colony Stimulating Factor Consult

Adult Colony Stimulating Factor Consult


CSF should be continued until absolute neutrophil count (ANC) is >1500/μL for 2 days or >1000/μL for 3 days

Daily complete blood count (CBC) with differential is recommended

  • Formal documentation via progress note within 24 hours of initial consult start time
  • Document within the electronic medical record with every change in CSF regimen
  • Document at a minimum of every 7 days
  • Document at consult discontinuation or sign-off
    • Pharmacist will discontinue filgrastim once ANC is >1500/μL for 2 days or >1000/μL for 3 days, but the consult will remain active for an additional 48 hrs
    • Pharmacist will sign off the consult if ANC remains >1000/μL for 48 hrs after the filgrastim order is discontinued

More Information

  1. Smith TJ, Bohlke K, Lyman GH, et al. Recommendations for the Use of WBC Growth Factors: American Society of Clinical Oncology Clinical Practice Guideline Update. J ClinOncol.2015;33(28):3199-3212.
  2. National Comprehensive Cancer Network. Hematopoietic Growth Factors (Version 4.2021). Accessed June 7, 2021.
  3. Common Terminology Criteria for Adverse Events (CTCAE), Version 4.03, May 2009, National Institutes of Health, National Cancer Institute. Available at: Accessed June 7, 2021.