Per NCCN guidelines, an older patient with a prior neutropenic episode would be a candidate to receive what to reduce neutropenia risk?

• A. True
• B. False
• C. Only if infection occurs
• D. Never in elderly patients

Answer: (A)

Prophylactic growth factor support, such as G-CSF, is used to lower the risk and severity of neutropenia and febrile neutropenia in patients receiving myelosuppressive chemotherapy. When an older patient has had a prior neutropenic episode, their risk of recurrence in future cycles is higher, and advanced age adds to that risk. NCCN guidelines therefore consider them a candidate for G-CSF prophylaxis in subsequent cycles to reduce neutropenia risk, prevent treatment delays, and lower the chance of infection-related hospitalization. The growth factor works by stimulating neutrophil production, shortening the duration of neutropenia and decreasing the likelihood of febrile neutropenia, which helps the chemotherapy plan stay on track. This approach is preventive rather than reactive to infection, and age alone does not preclude its use; in fact, older age with a prior neutropenic event supports considering prophylaxis.