Intensified chemotherapy regimens have improved overall and relapse-free survival in childhood cancers but have increased the incidence of chemotherapy-induced neutropenia (CIN). Granulocyte colony-stimulating factor (G-CSF) is widely used to accelerate neutrophil recovery and reduce infectious complications, yet few randomized studies have compared administration routes. This trial examined whether continuous intravenous drip (IVD) administration of G-CSF provides advantages over standard intravenous injection (IVI) in pediatric patients experiencing CIN.
This was a randomized, prospective, single-institution study. Twenty-eight pediatric participants were enrolled and randomized in a 1:1 ratio to the experimental or control arm. At study completion, 20 cases were eligible for statistical analysis. The report classifies the work as a randomized controlled trial published in Cancer Chemotherapy and Pharmacology.
Participants received G-CSF via one of two routes: continuous intravenous drip (IVD) or standard intravenous injection (IVI). The abstract identifies the comparison of these two administration methods as the trial intervention. Specifics such as exact dosing, infusion rates, duration of drip, timing relative to chemotherapy cycles, or product brand were not detailed in the abstract available here.
The primary endpoint was the duration from the onset of neutropenia to steady neutrophil recovery. Secondary endpoints included the safety profile, 7-day emergency return rate, and the occurrence of infectious or febrile events. These endpoints were pre-specified to evaluate both efficacy (speed of neutrophil recovery) and clinically relevant complications (febrile neutropenia and other infections), as well as tolerability of the two administration routes.
In the analyzed cohort, the mean time from CIN onset to neutrophil recovery was shorter in the IVD group compared with the IVI group. Reported values were 6.2 days for IVD and 7.6 days for IVI, representing a mean difference of 1.4 days. This difference reached statistical significance (P = 0.0068) per the abstract.
A secondary, clinically important finding was a lower incidence of febrile neutropenia (FN) in the IVD arm: 15% in the IVD group versus 50% in the IVI group (P = 0.0407). The abstract indicates that this reduction in FN incidence was statistically significant.
Other secondary outcomes such as the 7-day emergency return rate and the precise number or types of infectious events were listed among endpoints but detailed results for those measures are not reported in the abstract text provided here.
The authors state that adverse effects (AEs) were comparable between the IVD and IVI groups. The abstract does not enumerate specific adverse events, their severity grading, or any AE-related study discontinuations. Therefore, no additional safety details beyond the assertion of comparable AE profiles can be reliably reported from the provided source material.
Ethical approval was obtained from the Institutional Review Board of Chang Gung Memorial Hospital (IRB identifier: 202301323A3). The study was conducted in accordance with the Declaration of Helsinki, and informed consent and consent to publish were provided by legal guardians of the participants. The published record lists the study as a randomized controlled trial and provides PMID 42827181 and DOI 10.1007/s00280-026-04966-x.
In this single-institution randomized pediatric trial, continuous intravenous drip (IVD) administration of G-CSF was associated with a faster recovery of neutrophil counts (mean 6.2 vs. 7.6 days) and a lower incidence of febrile neutropenia (15% vs. 50%) compared with intravenous injection (IVI). Adverse effects were reported as comparable between arms.
These results suggest that the IVD route of G-CSF administration may offer a supportive-care advantage for pediatric oncology patients with CIN by shortening the duration of neutropenia and reducing febrile complications. However, the abstract does not provide full protocol details, dosing regimens, baseline characteristics, or comprehensive secondary outcome data; these items should be reviewed in the full publication before changing clinical practice. The trial was approved by an institutional review board and obtained guardian consent as reported.