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Despite the use of prophylactic factor concentrates, some patients continue to suffer frequent spontaneous bleeds.
Overall, the conclusions of the meta-analyses and reports are in contrast with other recent reviews, which have concluded that adequate vitamin D supplementation is an important prophylactic factor for immunity, autoimmunity, CVD, cancer, fertility, pregnancy, dementia, and mortality [ 77].
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25 The cause of these differences between different parts of the world could be specific climatic and prophylactic factors of these communities.
Although this group of patients had prior systemic therapy and often had comorbidities, future studies on this class of agent may need to consider the use of prophylactic growth factor support to limit myelosuppression to the patients.
We conclude that the use of prophylactic growth factor support was associated with a high proportion of chemotherapy cycles that were delivered on schedule and at full dose.
Prophylactic growth factor support was not allowed.
In patients who experienced grade 4 neutropenia, prophylactic growth factor support was recommended in subsequent cycles.
At the time the trial was designed, prophylactic growth factor support was not utilized on this trial as per standard of care.
It remains unclear, if this effect was diminished by the use of prophylactic growth factor or the combined effect of 3 cytotoxic drugs.
We could show now for the first time that Caucasian patients with both genotypes AA and AT are more prone to severe leucopenia in the first cycle of TPF treatment in comparison to patients with TT genotype despite prophylactic growth factor use in all patients.
Moreover, in our study no prophylactic growth factors were allowed, which in contrast were administered in the two published phase I studies.
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