25 下列有關白血球群落刺激因子（colony-stimulating factor, CSF）之使用，何者正確？
(A) 劑量係依白血球下降程度而調整
(B) 於化學治療療程開始前即應給予 CSF
(C) CSF 停止使用後，嗜中性白血球數目可能會下降約 50%
(D) 所有 febrile neutropenia 的病人皆應給予 CSF 治療

(A)看是使用哪種(***注意單位)

     filgrastim(G-CSF): 5mcg/kg

     peglyated G-CSF: 6mg/cycle

    sargramostim(GM-CSF): 250mcg/mm2

(B)給法

     filgrastim(G-CSF): 在化療前後24hr停藥

     peglyated G-CSF: 在化療前14天道化療後24hr停藥

(D)看情況

• -CSF should not be used routinely in patients with neutropenia who are afebrile (ASCO Strong recommendation, High-quality evidence)
• -consider CSF for patients with fever and neutropenia at high risk for infection-associated complications or who have prognostic factors predictive of poor clinical outcomes, including (ASCO Strong recommendation, High-quality evidence)
  • 1.expected prolonged (> 10 days) and profound (< 0.1 × 10⁹/L) neutropenia
  • 2.>65 years old
  • 3.uncontrolled primary disease
  • 4.pneumonia
  • 5.hypertension and multiorgan dysfunction (sepsis syndrome)
  • 6.invasive fungal infection
  • 7.hospitalization at time of fever development

ref: DynaMed [Internet]. Ipswich (MA): EBSCO Information Services. 1995 - . Record No. T903015, Febrile Neutropenia; [updated 2019 Jul 17, cited]