# The Use of Granulocyte Colony-Stimulating Factor as Primary Prophylaxis in Patients Undergoing Chemotherapy: An Experience of Moroccan Oncologists

## TL;DR

Moroccan oncologists often avoid prescribing G-CSF for intermediate-risk cancer patients due to cost, despite its benefits in preventing febrile neutropenia.

## Contribution

The study identifies cost as a major barrier to G-CSF use in intermediate-risk patients in Morocco.

## Key findings

- Most oncologists follow G-CSF guidelines for high-risk patients but avoid it for intermediate-risk due to cost.
- 82.9% of participants are medical oncologists, with most practicing in teaching hospitals.
- Only 35.35% of eligible oncologists participated in the study.

## Abstract

Febrile neutropenia (FN) is a frequent and serious emergency for oncologic patients undergoing chemotherapy. Using granulocyte colony-stimulating factor (G-CSF) as primary prophylaxis of febrile neutropenia is an integral part of the management of cancer patients. Our study aims to identify the challenges that prevent Moroccan oncologists from prescribing G-CSF for primary prevention.

Seventy doctors participated in our study, with a participation rate of 35.35%. Twenty-two participants had at least five years of experience in oncology. Most participants were medical oncologists (82.9%), and two-thirds of them practiced in teaching hospitals. Regarding the use of G-CSF in primary prevention, all participants complied with the recommendations for FN risk assessment and the prescription of G-CSF for prophylaxis in patients at high risk of FN (>20%). However, their use in intermediate-risk patients remains limited mainly by the cost of these drugs (45.7% of participants).

FN remains a dreadful complication in oncology. Since the introduction of G-CSF into standard oncology practice, particularly in primary prevention, the management of certain patients has improved considerably. Nevertheless, the indications for G-CSF in our context, essentially in intermediate-risk patients, are uncertain.