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Chemotherapy-induced neutropenia can cause complications that result in dose reductions or treatment delays that can, in turn, compromise clinical outcomes. Although the prophylactic use of colony-stimulating factors (CSFs) can reduce the risk, severity, and duration of severe and febrile neutropenia, they are not routinely administered to all patients undergoing myelosuppressive chemotherapy because of the costs. Selective use may, however, enhance their cost-effectiveness. These guidelines discuss the preventative or prophylactic use of recombinant human granulocyte-CSF to reduce the incidence, length, and severity of chemotherapy-related neutropenia and and prevent life-threatening complications. For the most recent version of the guidelines, please visit NCCN.org

Recognizing the increased risk of VTE in cancer patients is the first step in preventing the occurrence of VTE and promptly identifying VTE in these patients. The panel recommends VTE thromboprophylaxis for all hospitalized patients with cancer who do not have contraindications to this therapy, and also emphasizes that an increased level of clinical suspicion of VTE should be maintained for cancer patients. After hospital discharge, the panel recommends that cancer patients in a high-risk setting for VTE (e.g., patients who have undergone cancer surgery, those with multiple myeloma) continue to receive VTE prophylaxis, with the duration of anticoagulation determined by the clinical situation. Careful evaluation of cancer patients in whom VTE is suspected, and prompt treatment and follow-up for those diagnosed with VTE, is recommended after the cancer status of the patient is assessed and the risks and benefits of treatment are considered.