Prophylactic use of recombinant human granulocyte colony stimulating factor in children with high-risk neuroblastoma after chemotherapy

Objective To evaluate the effects of prophylactic recombinant human granulocyte colony stimulating factor(rhGCSF) treatment on high-risk neuroblastoma in children after chemotherapy. Methods A retrospective analysis was performed on the clinical data about 62 children with neuroblastoma admitted to the first medical center of Chinese PLA General Hospital from January 2013 to July 2018. Of them, 11 cases were in stage Ⅲ, and 51 cases were in stage Ⅳ with 28 cases had bone marrow metastasis. All children were treated with CDV protocol(cyclophosphamide + doxorubicin + vincristine), and they were divided into two groups, prophylactic group(n=29) with prophylactic use of rhG-CSF on the first and second day after chemotherapy, and control group(n=33) who received rhG-CSF after neutropenia developed. All children received a dose of 5μg/kg of rhG-CSF until ANC >1.5×10⁹/L. The duration of neutropenia and infection, interval between courses of chemotherapy in two groups were comparatively analyzed. Results The incidence of neutropenia in both two groups were 100%. The prophylactic group had a shorter duration of neutropenia(8.6±1.9 d vs 13.3±2.2 d, P=0.010), a shorter interval between courses of chemotherapy(25.1±4.6 d vs 30.3±8.3 d,P=0.04) and a lower incidence of treatment delay(17.2% vs 51.5%, P=0.05) compared to the control group. There was no significant difference in infection rates between two groups(86.2% vs 93.9%, P=0.30), but the duration of infection was longer in the prophylactic group than that of the control group(6.3±3.8 d vs 8.2±3.5 d, P=0.048). No adverse reaction was found after the application of rhG-CSF in 62 patients. Conclusion The prophylactic use of rhG-CSF after chemotherapy is effective and safe for children with high-risk neuroblastoma.