title: Neutropenia: state of the knowledge part I.
abstract: OBJECTIVE
  To review neutrophil physiology, consequences of chemotherapy-induced neutropenia (CIN), CIN risk assessment models, national practice guidelines, the impact of febrile neutropenia and infection, and what is known and unknown about CIN.
  
  
  METHODS
  Extensive review and summary of published neutropenia literature, guidelines, meta-analyses, currently funded National Institutes of Health and Oncology Nursing Society studies, and invited expert panel symposium presentations.
  
  
  RESULTS
  A comprehensive review of current literature regarding CIN risk assessment, practice guidelines, management, impact on dose-dense and dose-intense cancer treatment, complications, costs related to hospitalizations, and treatment strategies has been compiled.
  
  
  CONCLUSIONS
  CIN is the most common dose-limiting toxicity of cancer therapy. Medical practice guidelines and risk assessment models for appropriate use of myeloid growth factors and management of febrile neutropenia have been developed to assess patients for CIN complications prechemotherapy and during CIN episodes. CIN affects patients, families, practitioners, and the healthcare system. Although much is known about this common chemotherapy complication, a great deal remains to be learned.
  
  
  CONCLUSIONS
  CIN is a serious and global problem in patients receiving cancer therapy. Oncology nurses need to critically analyze their own practices when assessing, managing, and educating patients and families about CIN.
authors.affiliation: School of Nursing, Columbia University, New York, NY, USA. an207@columbia.edu
authors.forename: Anita
authors.initials: A
authors.lastname: Nirenberg
authors.forename: Annette Parry
authors.initials: AP
authors.lastname: Bush
authors.forename: Arlene
authors.initials: A
authors.lastname: Davis
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Friese
authors.forename: Theresa Wicklin
authors.initials: TW
authors.lastname: Gillespie
authors.forename: Robert David
authors.initials: RD
authors.lastname: Rice
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy / Q000276:immunology / Q000451:nursing*; D009503:Neutropenia / Q000139:chemically induced* / Q000276:immunology / Q000451:nursing*; D009504:Neutrophils / Q000276:immunology; D009859:Oncology Nursing / Q000379:methods*; D017410:Practice Guidelines as Topic
chemical_list: D000970:Antineoplastic Agents