Treatment

Document Overview

Design and created by Guideline Central in participation with the American Society of Clinical Oncology.

Recommendations for the Use of White Blood Cell Growth Factors

American Society of Clinical Oncology

Publication Date: Feb 25, 2026

Page Last Updated: May 5, 2026

Recommendation Rating Definitions

Quality of Evidence
Term		Definitions
H	- High	We are very confident that the true effect lies close to that of the estimate of the effect
M	- Moderate	We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
L	- Low	Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect.
VL	- Very Low	We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect.

Strength of Recommendation
Term		Definitions
S	- Strong	In recommendations for an intervention, the desirable effects of an intervention outweigh its undesirable effects. In recommendations against an intervention, the undesirable effects of an intervention outweigh its desirable effects. All or almost all informed people would make the recommended choice for or against an intervention.
W	- Weak	In recommendations for an intervention, the desirable effects probably outweigh the undesirable effects, but appreciable uncertainty exists. In recommendations against an intervention, the undesirable effects probably outweigh the desirable effects, but appreciable uncertainty exists. Most informed people would choose the recommended course of action, but a substantial number would not.

GRADE Handbook, Schünemann, et al. 2013.

Document Overview

Document Title: Recommendations for the Use of White Blood Cell Growth Factors

Authoring Society: American Society of Clinical Oncology

Document Publication Date: Feb 25, 2026

Page Last Reviewed/Updated: May 5, 2026

Document Type: Guideline

Country of Publication: United States

Full Text Freely Available: Yes

Full Text Guideline: ascopubs.org/doi/10.1200/JCO-25-02938

Source Citation: Gyawali B, Bohlke K, Dickter JK, et al. White Blood Cell Growth Factors: ASCO Guideline Update. J Clin Oncol. 2026 Feb 25. doi: 10.1200/JCO-25-02958

Supplemental Implementation Resources

Document Scope, Criteria, and Use Cases

Document Objectives: Foster the appropriate use of hematopoietic colony-stimulating factors (CSFs) based on high-quality evidence from controlled clinical trials and a comprehensive understanding of the specific patient, disease, and treatment factors associated with the risk of neutropenic complications.

Scope: Assessment and Screening, Management, Treatment

Keywords: WBC, White Blood Cell Growth Factors

Target Patient Population: Adults or children with a solid tumor or lymphoma treated with chemotherapy.

Target Provider Population: Medical oncologists, hematologists, oncology nurses, other clinicians who care for patients with cancer

Inclusion Criteria: Male, Female, Adolescent, Adult, Child, Older Adult

Health Care Settings: Ambulatory, Hospital, Outpatient

Intended Users: Nurse, Nurse Practitioner, Physician, Physician Assistant

Recommendation Development Processes & Methodology

Supplemental Methodology Resources: Data Supplement Methodology Supplement

Number of Source Documents: 66

Literature Search Start Date: Saturday, October 1, 2005

Literature Search End Date: Tuesday, September 30, 2014

Includes peer/external review process?: Yes

Includes public comment process?: No

Methodologist involvement?: Yes

Patient involvement?: Yes

Includes multi-disciplinary group?: Yes

Includes systematic review?: Yes

Grades quality of strength of evidence?: Yes

Grades quality of strength of recommendation?: Yes

Discloses funding source?: Yes

Discloses conflicts of interest?: Yes

Includes benefits/harms analysis with recommendations?: Yes

Identifies study selection process?: Yes

Identifies study selection criteria?: Yes

Identifies methods used to evaluate and analyze the evidence?: Yes

Identifies key questions addressed by the systematic review?: Yes

Identifies search strategy?: Yes

Recommendations for the Use of White Blood Cell Growth Factors

Treatment

Recommendation 1.1.

Recommendation 1.2.

Recommendation 1.3.

Recommendation 2.1.

Recommendation 3.1.

Recommendation 3.2.

Recommendation 3.3.

Recommendation 4.1.

Recommendation 4.2.

Recommendation 4.3.

Recommendation 5.1.

Recommendation 6.1.

Recommendation Rating Definitions

Document Overview

Supplemental Implementation Resources

Document Scope, Criteria, and Use Cases

Recommendation Development Processes & Methodology