We are pleased to receive and reply to our colleagues’ letter about the possible negative impact of ‘prophylactic granulocyte colony-stimulating factor’ (G-CSF) in the context of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. We have acknowledged several times that our paper should not be interpreted as a formal guideline. We aimed to highlight the reasoning process that should accompany therapeutic decisions. Every suggested treatment algorithm must be properly assessed and adjusted according to several factors which are certainly country-specific and health system-specific.
Having said that, during the pandemic, the risk of coinfections in patients with cancer, specifically lung cancer on active chemotherapy, must be reduced to a minimum. Therefore, avoiding or minimising prolonged neutropaenia, through G-CSF, becomes essential. Perhaps, even more importantly, avoiding hospitalisations, at a time when hospital beds could be in short supply and the risk of transmission of SARS-CoV-2 is non-negligible, is crucial.