背景：粒细胞集落刺激因子（G-CSF）广泛用于发热性中性粒细胞减少症（FN）的初级预防。日本有两种G-CSF，即与聚乙二醇化学结合的G-CSF（PEGG-CSF），单剂量提供持久的效果，和非聚乙二醇结合的G-CSF（非PEGG-CSF），必须连续管理几天。
方法：本研究通过对文献的系统回顾，研究了这些治疗对FN一级预防的效用。使用PubMed对相关研究进行了详细的文献检索，Ichushi-Web,还有Cochrane图书馆.数据由两名审阅者独立提取和评估。进行了定性分析或荟萃分析以评估六个结果。
结果：通过第一次和第二次筛查，提取23和18篇文章进行定性综合和荟萃分析，分别。PEGG-CSF组的FN发生率明显低于非PEGG-CSF组，证据质量/确定性强。其他结果的差异，比如总体生存率，感染相关死亡率，中性粒细胞减少症的持续时间（小于500/μL），生活质量,和痛苦，不明显。
结论：对于FN的一级预防，强烈建议单剂量PEGG-CSF治疗优于多剂量非PEGG-CSF治疗。
BACKGROUND: Granulocyte colony-stimulating factor (G-CSF) is widely used for the primary prophylaxis of febrile neutropenia (FN). Two types of G-CSF are available in Japan, namely G-CSF chemically bound to polyethylene glycol (PEG G-CSF), which provides long-lasting effects with a single dose, and non-polyethylene glycol-bound G-CSF (non-PEG G-CSF), which must be sequentially administrated for several days.
METHODS: This current study investigated the utility of these treatments for the primary prophylaxis of FN through a systematic review of the literature. A detailed literature search for related studies was performed using PubMed, Ichushi-Web, and the Cochrane Library. Data were independently extracted and assessed by two reviewers. A qualitative analysis or meta-analysis was conducted to evaluate six outcomes.
RESULTS: Through the first and second screenings, 23 and 18 articles were extracted for qualitative synthesis and meta-analysis, respectively. The incidence of FN was significantly lower in the PEG G-CSF group than in the non-PEG G-CSF group with a strong quality/certainty of evidence. The differences in other outcomes, such as overall survival, infection-related mortality, the duration of neutropenia (less than 500/μL), quality of life, and pain, were not apparent.
CONCLUSIONS: A single dose of PEG G-CSF is strongly recommended over multiple-dose non-PEG G-CSF therapy for the primary prophylaxis of FN.
