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Guidelines
Adult Colony Stimulating Factor Consult

Adult Colony Stimulating Factor Consult

Overview

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). https://www.nccn.org/professionals/physician_gls/pdf/growthfactors.pdf. 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: https://evs.nci.nih.gov/ftp1/CTCAE/CTCAE4.03/CTCAE4.032010-06-14QuickReference_5x7.pdf. Accessed June 7, 2021.