Optimizing the management of chemotherapy-induced neutropenia.
Chemotherapy-induced neutropenia (CIN), the most common dose-limiting toxicity of cancer chemotherapy, is associated with numerous clinical, personal, and economic consequences. The principal strategies for managing CIN are reducing the dose intensity of the chemotherapy, using antibiotics, and using colony-stimulating factors (CSFs). Reducing or delaying the chemotherapy dose is effective, but this can compromise treatment outcomes. Antibiotics can be lifesaving, but they are associated with numerous adverse effects and the emergence of resistant pathogens. The granulocyte CSF (G-CSF) filgrastim can reduce the incidence, duration, and severity of CIN, as well as the risk of infection, in patients treated with myelosuppressive chemotherapy. The availability of pegfilgrastim, a sustained-duration G-CSF that has benefits comparable to those of filgrastim with a single injection per chemotherapy cycle, has simplified CSF therapy.
Dale
David C
DC
Department of Medicine, University of Washington, Seattle, WA 98195, USA. dcdale@u.washington.edu
D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002986:Clinical Trials as Topic; D003692:Delayed-Action Preparations; D019468:Disease Management; D004198:Disease Susceptibility; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005334:Fever / Q000209:etiology; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D016298:Hematopoietic Cell Growth Factors / Q000627:therapeutic use*; D006801:Humans; D017053:Infection Control; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy; D009503:Neutropenia / Q000139:chemically induced / Q000188:drug therapy* / Q000191:economics; D011092:Polyethylene Glycols; D011788:Quality of Life; D011994:Recombinant Proteins; D018570:Risk Assessment
D000970:Antineoplastic Agents; D003692:Delayed-Action Preparations; D016298:Hematopoietic Cell Growth Factors; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; C455861:pegfilgrastim; D011092:Polyethylene Glycols; D000069585:Filgrastim