***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: After informed consent , 86 patients with advanced cancer undergoing potentially myelosuppressive cytotoxic chemotherapy  were r and omized to receive placebo or subcutaneous granulocyte-colony stimulating factor ( G-CSF ) 5 micrograms/Kg/day in order to prevent severe neutropenia and its related morbidity . The incidence of neutropenia ( absolute neutrophil count < 1,000/mm3 ) was significantly reduced in patients receiving G-CSF than in controls ( 18 % versus 42 % ; P < 0.05 ) . The duration of neutropenia was also shortened by the administration of G-CSF ( 4.8 versus 8.2 days ; P < 0.05 ) . Therapy with G-CSF has also a positive impact on the dose-intensity of employed regimens . Patients treated with G-CSF showed oral fungal disease in 9 % of cases , while control patients had a 21 % incidence ( NS ) . Patients treated with G-CSF received 91 % of the programmed dose-intensity as compared to 71 % of control patients ( P < 0.05 ) . These data strengthen the clinical usefulness of G-CSF in the prevention of chemotherapy-related neutropenia , infections , and reduction in dose-intensity . Further studies are required to establish if the increase in dose-intensity allowed by G-CSF treatment may positively influence the outcome of cancer patients BACKGROUND Neutropenia is common in patients receiving myelotoxic chemotherapy .  Pegfilgrastim , a sustained- duration filgrastim is a once-per-cycle therapy for prophylactic neutrophil support . PATIENTS AND METHODS Women , treated with four cycles of doxorubicin/docetaxel chemotherapy every 21 days , received pegfilgrastim or filgrastim 24 h after chemotherapy as a single subcutaneous injection per chemotherapy cycle ( pegfilgrastim 30 , 60 or 100 microg/kg ) or daily subcutaneous injections ( filgrastim 5 microg/kg/day ) . Safety , efficacy and pharmacokinetics were analyzed . RESULTS The incidence of grade 4 neutropenia in cycle 1 was 95 , 90 and 74 % , in patients who received pegfilgrastim 30 , 60 and 100 microg/kg , respectively , and 76 % in patients who received filgrastim .  Mean duration of grade 4 neutropenia in cycle 1 was 2.7,2 and 1.3 days for doses of pegfilgrastim , and 1.6 days for filgrastim . The pharmacokinetics of pegfilgrastim were non-linear and dependent on both dose and neutrophil count . Pegfilgrastim  serum concentration was sustained until the neutrophil nadir occurred then declined rapidly as neutrophils started to recover , consistent with a self-regulating neutrophil-mediated clearance mechanism . The safety profiles of pegfilgrastim and filgrastim were similar . CONCLUSIONS A single subcutaneous injection of pegfilgrastim 100 microg/kg provided neutrophil support and a safety profile comparable to daily subcutaneous injections of filgrastim during multiple chemotherapy cycles Background Recombinant granulocyte colony-stimulating factors ( G-CSFs ) such as Filgrastim are used to treat chemotherapy-induced neutropenia . We investigated a new G-CSF , XM02 , and compared it to Neupogen ™ after myelotoxic chemotherapy in breast cancer ( BC ) patients . Methods A total of 348 patients with BC receiving docetaxel/doxorubicin chemotherapy were r and omised to treatment with daily injections ( subcutaneous 5 μg/kg/day ) for at least 5 days and a maximum of 14 days in each cycle of XM02 ( n = 140 ) , Neupogen ™ ( n = 136 ) or placebo ( n = 72 ) . The primary endpoint was the duration of severe neutropenia ( DSN ) in cycle 1 . Results The mean DSN in cycle 1 was 1.1 , 1.1 , and 3.9 days in the XM02 , Neupogen ™ , and placebo group , respectively . Superiority of XM02 over placebo and equivalence of XM02 with Neupogen ™ could be demonstrated . Toxicities were similar between XM02 and Neupogen ™ . Conclusion XM02 was superior to placebo and equivalent to Neupogen ™ in reducing DSN after myelotoxic chemotherapy . Trial Registration Current Controlled Trials IS RCT PURPOSE We evaluated the efficacy of pegfilgrastim to reduce the incidence of febrile neutropenia associated with docetaxel in breast cancer patients . PATIENTS AND METHODS Patients were r and omly assigned to either placebo or pegfilgrastim 6 mg subcutaneously on day 2 of each 21-day chemotherapy cycle of 100 mg/m(2 ) docetaxel . The primary end point was the percentage of patients developing febrile neutropenia ( defined as body temperature > /= 38.2 degrees C and neutrophil count < 0.5 x 10(9)/L on the same day of the fever or the day after ) . Secondary end points were incidence of hospitalizations associated with a diagnosis of febrile neutropenia , intravenous ( IV ) anti-infectives required for febrile neutropenia , and the ability to maintain planned chemotherapy dose on time . Patients with febrile neutropenia were converted to open-label pegfilgrastim in subsequent cycles . RESULTS Nine hundred twenty-eight patients received placebo ( n = 465 ) or pegfilgrastim ( n = 463 ) . Patients receiving pegfilgrastim , compared with patients receiving placebo , had a lower incidence of febrile neutropenia ( 1 % v 17 % , respectively ; P < .001 ) , febrile neutropenia-related hospitalization ( 1 % v 14 % , respectively ; P < .001 ) , and use of IV anti-infectives ( 2 % v 10 % , respectively ; P < .001 ) . The percentage of patients receiving the planned dose on time was similar between patients receiving pegfilgrastim and patients who initially received placebo ( 80 % and 78 % , respectively ) , as would be expected of the study design . Pegfilgrastim was generally well tolerated and safe , and the adverse events reported were typical of this patient population . CONCLUSION First and subsequent cycle use of pegfilgrastim with a moderately myelosuppressive chemotherapy regimen markedly reduced febrile neutropenia , febrile neutropenia-related hospitalizations , and IV anti-infective use PURPOSE This multicenter , r and omized , double-blind , active-control study was design ed to determine whether a single subcutaneous injection of pegfilgrastim ( SD/01 , sustained- duration filgrastim ; 100 microg/kg ) is as safe and effective as daily filgrastim ( 5 microg/kg/d ) for reducing neutropenia in patients who received four cycles of myelosuppressive chemotherapy . PATIENTS AND METHODS Sixty-two centers enrolled 310 patients who received chemotherapy with docetaxel 75 mg/m(2 ) and doxorubicin 60 mg/m(2 ) on day 1 of each cycle for a maximum of four cycles . Patients were r and omized to receive on day 2 either a single subcutaneous injection of pegfilgrastim 100 microg/kg per chemotherapy cycle ( 154 patients ) or daily subcutaneous injections of filgrastim 5 microg/kg/d ( 156 patients ) . Absolute neutrophil count ( ANC ) , duration of grade 4 neutropenia , and safety parameters were monitored . RESULTS One dose of pegfilgrastim per chemotherapy cycle was comparable to daily subcutaneous injections of filgrastim with regard to all efficacy end points , including the duration of severe neutropenia and the depth of ANC nadir in all cycles . Febrile neutropenia across all cycles occurred less often in patients who received pegfilgrastim . The difference in the mean duration of severe neutropenia between the pegfilgrastim and filgrastim treatment groups was less than 1 day . Pegfilgrastim was safe and well tolerated , and it was similar to filgrastim .  Adverse event profiles in the pegfilgrastim and filgrastim groups were similar . CONCLUSION A single injection of pegfilgrastim 100 microg/kg per cycle was as safe and effective as daily injections of filgrastim 5 microg/kg/d in reducing neutropenia and its complications in patients who received four cycles of doxorubicin 60 mg/m(2 ) and docetaxel 75 mg/m(2 ) The aim of this study was to determine the usefulness of recombinant human granulocyte colony stimulating factor ( r-metHuG-CSF ) following conventional chemotherapy for small cell lung cancer . 130 previously untreated patients were r and omised to receive either r-metHuG-CSF ( 230 micrograms/m2 ) or placebo on days 4 - 17 following CDE ( cyclophosphamide , doxorubicin and etoposide ) chemotherapy . Over all cycles , 53 % of 64 patients on placebo and only 26 % of 65 patients on r-metHuG-CSF had at least one experience of neutropenia with fever defined as a neutrophil count less than 1.0 x 10(9)/l and a temperature > or = 38.2 degrees C ( P < 0.002 ) . It result ed in a reduction in the requirement for parenteral antibiotics from 58 % in placebo patients compared with 37 % in the r-metHuG-CSF group ( P < 0.02 ) , and a significant reduction in the incidence of infection-related hospitalisation . Chemotherapy doses were reduced by 15 % or more at least once in 61 % of the placebo group compared with 29 % in the r-metHuG-CSF group ( P < 0.001 ) . 47 % of the patients treated with placebo and 29 % of the patients treated with r-metHuG-CSF experienced at least one cycle with a delay of 2 days or more in the administration of chemotherapy ( P < 0.04 ) . r-metHuG-CSF was well tolerated . There were no significant differences between the two groups in terms of response or survival The effect of granulocyte colony-stimulating factor ( G-CSF ) on neutropenia , infection , and cytotoxic chemotherapy administration was studied in a r and omized trial in patients receiving intensive weekly chemotherapy for non-Hodgkin 's lymphoma ( NHL ) . Eighty patients ( aged 16 to 71 years ) with high- grade NHL ( Kiel ) of any stage were r and omized to receive VAPEC-B chemotherapy alone ( 39 patients ) or with G-CSF administered as a daily subcutaneous dose of 230 micrograms/m2 ( 41 patients ) .  Prophylactic ketoconazole and cotrimoxazole were administered to all patients throughout treatment . The protocol specified identical dose modification and antibiotic treatment criteria bor both groups . Neutropenia ( absolute neutrophil count [ ANC ] less than 1.0 x 10(9)/L ) occurred in 15 of 41 ( 37 % ) of the G-CSF-treated patients and in 33 of 39 ( 85 % ) of the controls , giving a relative risk for control patients of 2.31 ( 95 % confidence interval [ CI ] , [ 1.51 , 3.54 ] ; P = .00001 ) . Fever ( greater than or equal to 37.5 degrees C ) with neutropenia ( ANC less than 1.0 x 10(9)/L ) occurred in 9 of 41 ( 22 % ) of the G-CSF group and in 17 of 39 ( 44 % ) of the controls ( relative risk for control , 2.26 ; 95 % CI [ 1.01 , 5.06 ] ; P = .04 ) . There were fewer treatment delays , with shorter duration ( P = .01 ) in patients receiving G-CSF .  Chemotherapy doses were reduced in 4 of 41 ( 10 % ) of the G-CSF patients and 13 of 39 ( 33 % ) of the controls ( P = .01 ) . The dose intensity of cytotoxic chemotherapy  was significantly increased in patients receiving G-CSF ( median of 95 % in G-CSF group compared with 83 % in control patients ) . Three vascular deaths occurred in the G-CSF group . Delays in the control group most commonly result ed from neutropenia ( 19 patients , compared with 2 patients in the G-CSF-treated group , P = .000007 ) . Severe mucositis was the major dose-limiting toxicity in G-CSF-treated patients , but did not occur more frequently than in controls ( 15 patients in each group ) . Overall , patients r and omized to receive G-CSF achieved a greater dose intensity than control patients , but this did not result in significant differences in drug toxicity ( other than neutropenia ) , intravenous antibiotic usage , or hospitalization between the two groups One hundred patients with advanced carcinoma undergoing highly cytotoxic chemotherapy were enrolled in a prospect i ve r and omized trial comparing subcutaneous G-CSF , thymopentin , a combination of the two , and placebo as preventive treatment of febrile leukopenia . Data from this study show that G-CSF was very active in reducing the incidence of chemotherapy- 
    Output:
    
Using MTC over all chemotherapy cycles , PP with filgrastim , pegfilgrastim , lenograstim , and lipegfilgrastim versus no G-CSF PP or placebo were associated with statistically significantly reduced FN risk .
FN risk was also significantly reduced with pegfilgrastim PP versus filgrastim PP .
Over all chemotherapy cycles , there was a numerical but statistically nonsignificant increase in the FN risk for lipegfilgrastim PP versus pegfilgrastim PP .
Using MTC in cycle 1 , PP with filgrastim , pegfilgrastim , and lipegfilgrastim versus no G-CSF PP or placebo were associated with statistically significantly reduced FN risk .
Conclusions In this meta- analysis , using MTC without adjustment for RDI , PP with all G-CSFs evaluated reduced the FN risk in patients receiving myelosuppressive chemotherapy .