Neutropenia: state of the knowledge part I.
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.
Nirenberg
Anita
A
School of Nursing, Columbia University, New York, NY, USA. an207@columbia.edu
Bush
Annette Parry
AP
Davis
Arlene
A
Friese
Christopher R
CR
Gillespie
Theresa Wicklin
TW
Rice
Robert David
RD
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
D000970:Antineoplastic Agents