title: [Prognostic factors for febrile neutropenia].
abstract: Cytotoxic chemotherapy suppresses the haematopoietic system, impairing host protective mechanisms and limiting the doses of chemotherapy that can be tolerated. Febrile neutropenia, the most serious haematological toxicity, is associated with the risk of life-threatening infections as well as chemotherapy dose reductions and delays that may compromise treatment outcomes. The recent literature in chemotherapy-induced neutropenia and its complications and impact was provided an update on research, and the implications for improving the management of patients with cancer who are treated with myelosuppressive chemotherapy was discussed. Despite its importance as the primary dose-limiting toxicity of chemotherapy, much concerning neutropenia and its consequences and impact remains unknown. Recent surveys indicate that neutropenia remains a prevalent problem associated with substantial morbidity, mortality, and costs. The colony-stimulating factors (CSFs) have been used effectively in a variety of clinical settings to prevent or treat febrile neutropenia and to assist patients receiving dose-intensive chemotherapy. A meta-analysis of the available randomized controlled trials (RCTs) has confirmed the efficacy of prophylactic CSFs. Much research has sought to identify risk factors that may predispose patients to neutropenic complications, including febrile neutropenia, in an effort to predict better which patients are at risk and to use preventive strategies, such as prophylactic colony-stimulating factors, more cost-effectively. Research in quantifying the risk of neutropenic complications may make it possible in the near future to target patients at greater risk with appropriate preventive strategies, thereby maximizing the benefits and minimizing the costs.
authors.affiliation: Centre Léon-Bérard, 28, rue Laennec, 69008 Lyon, France. ray@lyon.fnclcc.fr
authors.forename: Isabelle
authors.initials: I
authors.lastname: Ray-Coquard
authors.forename: Christophe
authors.initials: C
authors.lastname: Borg
authors.forename: Thomas
authors.initials: T
authors.lastname: Bachelot
authors.forename: Jérome
authors.initials: J
authors.lastname: Fayette
authors.forename: Laura
authors.initials: L
authors.lastname: Zufferey
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Guastalla
authors.forename: Hervé
authors.initials: H
authors.lastname: Ghesquière
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Blay
authors.forename: Catherine
authors.initials: C
authors.lastname: Sebban
authors.forename: Perrine
authors.initials: P
authors.lastname: Marec-Bérard
authors.forename: Pierre
authors.initials: P
authors.lastname: Biron
mesh_terms: D019072:Antibiotic Prophylaxis; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D004198:Disease Susceptibility; D005334:Fever / Q000139:chemically induced* / Q000401:mortality / Q000517:prevention & control; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006397:Hematinics / Q000627:therapeutic use*; D016298:Hematopoietic Cell Growth Factors / Q000627:therapeutic use; D006801:Humans; D009503:Neutropenia / Q000139:chemically induced* / Q000401:mortality / Q000517:prevention & control; D011379:Prognosis; D011994:Recombinant Proteins
chemical_list: D000970:Antineoplastic Agents; D006397:Hematinics; D016298:Hematopoietic Cell Growth Factors; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor