---
title: "Intravenous drip G-CSF shortens neutropenia and lowers febrile neutropenia in pediatric oncology"
id: "pubmed-42827181"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42827181"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42827181/"
doi: "10.1007/s00280-026-04966-x"
published_at: "2026-10-03T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Intravenous drip G-CSF shortens neutropenia and lowers febrile neutropenia in pediatric oncology
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42827181
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42827181/)
- **DOI:** [10.1007/s00280-026-04966-x](https://doi.org/10.1007%2Fs00280-026-04966-x)
- **Published At:** 2026-10-03T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This randomized, prospective, single-institution trial compared two routes of **granulocyte colony-stimulating factor (G-CSF)** administration in pediatric oncology patients with chemotherapy-induced neutropenia (CIN): continuous intravenous drip (IVD) versus intravenous injection (IVI). - Twenty-eight participants were enrolled and randomized 1:1; 20 cases were eligible for final statistical analysis. - The primary endpoint was time from onset of neutropenia to steady neutrophil recovery. Secondary endpoints included safety, 7-day emergency return rate, and infectious or febrile events. - Mean time from CIN to neutrophil recovery was 6.2 days in the **IVD** group versus 7.6 days in the **IVI** group, with a mean difference of 1.4 days (P = 0.0068). - Incidence of **febrile neutropenia (FN)** was significantly lower in the IVD group compared with the IVI group (15% vs. 50%; P = 0.0407). - Adverse effects were reported as comparable between the two administration routes. - The authors conclude that the **IVD route of G-CSF** leads to faster neutrophil recovery and reduces FN risk, suggesting IVD may be a preferable supportive-care option for cancer patients with CIN. - Ethical approval and guardian consent were obtained; the trial was approved by the Institutional Review Board of Chang Gung Memorial Hospital (IRB identifier: 202301323A3). - The study population was pediatric (MeSH terms include Child, Adolescent, Child, Preschool); further details on baseline characteristics, exact G-CSF dosing regimens, and certain protocol specifics were not reported in the abstract presented here.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 Divisions of Hematology/Oncology, Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University, 5 Fu-Shin Street, Kwei-Shan, 333, Taoyuan, Taiwan. g987669@gmail.com. * 2 Divisions of Hematology/Oncology, Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University, 5 Fu-Shin Street, Kwei-Shan, 333, Taoyuan, Taiwan. * 3 Department of Nursing, Chang Gung Memorial Hospital, Taoyuan, Taiwan. * PMID: **42827181** * DOI: [ 10.1007/s00280-026-04966-x ](https://doi.org/10.1007/s00280-026-04966-x) Item in Clipboard Randomized Controlled Trial # Continuous infusion of granulocyte colony-stimulating factor is associated with an advantage in neutrophil recovery in pediatric oncologic disorders Yi-Lun Wang et al. Cancer Chemother Pharmacol. 2026. Show details Display options Display options Format Abstract PubMed PMID Cancer Chemother Pharmacol Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Cancer+Chemother+Pharmacol%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Cancer+Chemother+Pharmacol%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42827181/) . 2026 Oct 3;96(1):113. doi: 10.1007/s00280-026-04966-x. ### Authors [Yi-Lun Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+YL&cauthor_id=42827181)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42827181/#short-view-affiliation-1 "Divisions of Hematology/Oncology, Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University, 5 Fu-Shin Street, Kwei-Shan, 333, Taoyuan, Taiwan. g987669@gmail.com."), [Tsung-Yen Chang](https://pubmed.ncbi.nlm.nih.gov/?term=Chang+TY&cauthor_id=42827181)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42827181/#short-view-affiliation-2 "Divisions of Hematology/Oncology, Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University, 5 Fu-Shin Street, Kwei-Shan, 333, Taoyuan, Taiwan."), [Shih-Hsiang Chen](https://pubmed.ncbi.nlm.nih.gov/?term=Chen+SH&cauthor_id=42827181)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42827181/#short-view-affiliation-2 "Divisions of Hematology/Oncology, Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University, 5 Fu-Shin Street, Kwei-Shan, 333, Taoyuan, Taiwan."), [Yi-Wen Hsiao](https://pubmed.ncbi.nlm.nih.gov/?term=Hsiao+YW&cauthor_id=42827181)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42827181/#short-view-affiliation-3 "Department of Nursing, Chang Gung Memorial Hospital, Taoyuan, Taiwan."), [Yu-Chuan Wen](https://pubmed.ncbi.nlm.nih.gov/?term=Wen+YC&cauthor_id=42827181)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42827181/#short-view-affiliation-3 "Department of Nursing, Chang Gung Memorial Hospital, Taoyuan, Taiwan."), [Tang-Her Jaing](https://pubmed.ncbi.nlm.nih.gov/?term=Jaing+TH&cauthor_id=42827181)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42827181/#short-view-affiliation-2 "Divisions of Hematology/Oncology, Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University, 5 Fu-Shin Street, Kwei-Shan, 333, Taoyuan, Taiwan.") ### Affiliations * 1 Divisions of Hematology/Oncology, Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University, 5 Fu-Shin Street, Kwei-Shan, 333, Taoyuan, Taiwan. g987669@gmail.com. * 2 Divisions of Hematology/Oncology, Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University, 5 Fu-Shin Street, Kwei-Shan, 333, Taoyuan, Taiwan. * 3 Department of Nursing, Chang Gung Memorial Hospital, Taoyuan, Taiwan. * PMID: **42827181** * DOI: [ 10.1007/s00280-026-04966-x ](https://doi.org/10.1007/s00280-026-04966-x) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID Linked Discoveries ## Abstract **Introduction:** The use of intensified chemotherapy has significantly improved overall survival (OS) and relapse-free survival (RFS) in cancer patients. However, it also increases the risk of chemotherapy-induced neutropenia (CIN). Granulocyte colony-stimulating factor (G-CSF) is commonly used to hasten neutrophil recovery, but limited research has focused on the superiority of different routes of G-CSF administration. **Materials and methods:** This was a randomized, prospective, single-institution study. Twenty-eight participants were enrolled and randomly assigned to experimental and control arms in a 1:1 ratio. At the end of the study, 20 cases were eligible for statistical analysis. 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. **Results:** The mean duration from CIN to neutrophil recovery was 6.2 days in the intravenous drip (IVD) group and 7.6 days in the intravenous injection (IVI) group (P = 0.0068). The mean difference between the two groups was 1.4 days. A significantly lower incidence of febrile neutropenia (FN) was observed in the IVD group compared to the IVI group (15% vs. 50%, P = 0.0407). Adverse effects (AEs) were comparable between the two groups. **Conclusions:** The IVD route of G-CSF administration leads to faster neutrophil recovery and reduces the risk of FN. All evaluable AEs are comparable between the two groups. These findings suggest that the IVD route may be a preferable option for optimizing supportive care in cancer patients with CIN. **Keywords:** Chemotherapy-induced neutropenia; G-CSF; Neutrophil recovery; Pediatric hematology/oncology; Toxicity. © 2026. The Author(s). [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement Declarations. Conflict of interest: The authors declare no competing interests. Ethics, Consent to Participate, and Consent to Publish: Ethical approval, as well as consent to participate and publish, were obtained through formal informed consent from the participants’ legal guardians. The study was conducted in accordance with the Declaration of Helsinki and was approved by the Institutional Review Board of Chang Gung Memorial Hospital (IRB identifier: 202301323A3). ## References 1. 1. Musta E, van Geloven N, Anninga J, Gelderblom H, Fiocco M (2022) Short-term and long-term prognostic value of histological response and intensified chemotherapy in osteosarcoma: a retrospective reanalysis of the BO06 trial. BMJ Open 12(5):e052941 - [DOI](https://doi.org/10.1136/bmjopen-2021-052941) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/35537786/) - [PMC](https://pmc.ncbi.nlm.nih.gov/articles/9092180/) 2. 1. Ash S, Yaniv I, Toledano H, Stein J, Kollender Y, Fenig E et al (2019) Improved Outcome in Local Ewing Sarcoma With an Intensified Pilot Treatment Protocol SCMCIE 94. J Pediatr Hematol Oncol 41(2):105–111 - [DOI](https://doi.org/10.1097/mph.0000000000001384) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/30570510/) 3. 1. Yamasaki K, Okada K, Soejima T, Kosaka Y, Nagashima T, Hara J (2020) Outcomes of Local Radiation and Intensified Combined Intrathecal Methotrexate and High-dose Chemotherapy for Intracranial Germ Cell Tumors. J Pediatr Hematol Oncol 42(7):e551–e557 - [DOI](https://doi.org/10.1097/mph.0000000000001820) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/32398600/) 4. 1. Sunami S, Sekimizu M, Takimoto T, Mori T, Mitsui T, Fukano R et al (2016) Prognostic Impact of Intensified Maintenance Therapy on Children With Advanced Lymphoblastic Lymphoma: A Report From the Japanese Pediatric Leukemia/Lymphoma Study Group ALB-NHL03 Study. Pediatr Blood Cancer 63(3):451–457 - [DOI](https://doi.org/10.1002/pbc.25824) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/26585702/) 5. 1. Tallen G, Ratei R, Mann G, Kaspers G, Niggli F, Karachunsky A et al (2010) Long-term outcome in children with relapsed acute lymphoblastic leukemia after time-point and site-of-relapse stratification and intensified short-course multidrug chemotherapy: results of trial ALL-REZ BFM 90. J Clin Oncol 28(14):2339–2347 - [DOI](https://doi.org/10.1200/jco.2009.25.1983) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/20385996/) Show all 46 references ## Publication types * Randomized Controlled Trial Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Randomized+Controlled+Trial%22%5Bpt%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Randomized+Controlled+Trial) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42827181/) ## MeSH terms * Adolescent Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Adolescent%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Adolescent) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42827181/) * Antineoplastic Agents* / administration & dosage Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Antineoplastic+Agents%2Fadministration+and+dosage%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Antineoplastic+Agents) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42827181/) * Antineoplastic Agents* / adverse effects Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Antineoplastic+Agents%2Fadverse+effects%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Antineoplastic+Agents) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42827181/) * Chemotherapy-Induced Febrile Neutropenia* / prevention & control Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Chemotherapy-Induced+Febrile+Neutropenia%2Fprevention+and+control%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Chemotherapy-Induced+Febrile+Neutropenia) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42827181/) * Child Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Child%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Child) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42827181/) * Child, Preschool Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Child%2C+Preschool%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Child%2C+Preschool) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42827181/) * Female Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Female%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Female) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42827181/) * Granulocyte Colony-Stimulating Factor* / administration & dosage Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Granulocyte+Colony-Stimulating+Factor%2Fadministration+and+dosage%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Granulocyte+Colony-Stimulating+Factor) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42827181/) * Granulocyte Colony-Stimulating Factor* / adverse effects Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Granulocyte+Colony-Stimulating+Factor%2Fadverse+effects%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Granulocyte+Colony-Stimulating+Factor) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42827181/) * Humans Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Humans%22%5BMeSH%5D&sort=date&sort_order=desc) * [
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