title: Lecture: management of chemotherapy-induced febrile neutropenia; guidelines and colony stimulating factors.
abstract: Chemotherapy-induced febrile neutropenia (FN) is a major risk factor for severe infections potentially fatal, and also a dose-limiting toxicity, so causing dose reductions and/or delays in scheduled chemotherapy. This lecture provides recommendations for the use of G-CSF in adult cancer patients at risk of chemotherapy-induced FN. If expected risk of FN is equal or superior to 20%, a primary prophylaxis of FN with G-CSF is recommended. Primary prophylaxis can be considered in case of intermediate 10-20% risk of FN, in presence of factors that increase the frequency/risk of FN, such as age >65, advanced disease, prior episode of FN, poor performance status, radiotherapy to a wide body area (>20%). In case of low risk of FN (<10%), primary prophylaxis is not recommended. We also described the differences in potency and efficacy between two G-CSF, lenograstim (glycosylated) and filgrastim (non-glycosylated), which should be considered when deciding the G-CSF for each patient, particularly in high risk settings for FN.
authors: Fondazione IRCCS-Istituto Nazionale Tumori, Milan, Italy. Giuseppe.Procopio@istitutotumori.mi.it
authors: Giuseppe
authors: G
authors: Procopio
authors: Monica
authors: M
authors: Niger
authors: Isabella
authors: I
authors: Testa
mesh_terms: D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D005334:Fever / Q000139:chemically induced / Q000150:complications / Q000517:prevention & control; D006031:Glycosylation; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D017408:Guidelines as Topic; D006801:Humans; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000188:drug therapy; D009503:Neutropenia / Q000139:chemically induced / Q000150:complications / Q000517:prevention & control*
chemical_list: D000276:Adjuvants, Immunologic; D000970:Antineoplastic Agents; D016179:Granulocyte Colony-Stimulating Factor