title: Defining the impact of the use of granulocyte colony stimulating factors on the incidence of chemotherapy-induced neutropenia in patients with gynecologic malignancies.
abstract: Purpose The objectives of this study were to characterize the incidence of chemotherapy-induced neutropenia (CIN) and febrile neutropenia (FN) with specific chemotherapy agents commonly used in the treatment of gynecologic malignancies, as well as defining the impact of granulocyte colony stimulating factors (G-CSF) on the prevention of CIN and FN in this patient population. Methods This retrospective analysis was conducted from a database of 635 gynecologic cancer patients who received chemotherapy between 1 September 2007 and 31 August 2008. A logistic regression analysis was conducted to determine the impact of potential covariates on the overall incidence of CIN. Results Overall, 28.3% of patients experienced CIN with one or more cycles chemotherapy, and 13.1% had treatment delays or dose reduction associated with CIN. The use of G-CSF prior to administration of chemotherapy resulted in a decrease in the incidence of CIN from 29.8% to 19.6% compared to no G-CSF use. No difference was observed in number of treatment delays or dose reductions in the 46 (7.2%) of gynecologic cancer patients that received G-CSF prophylaxis. Multivariate analysis found that both age and the number of current cycles jointly may predict risk of CIN. Conclusions Patients with gynecologic malignancies appear to be at a higher risk of development of neutropenia when treated with chemotherapy. The proactive use of G-CSF did decrease the risk of CIN by over 30%. Prospective study is warranted to determine the impact of G-CSF to reduce CIN in patients with gynecologic malignancies receiving chemotherapy.
authors.affiliation: 1 Division of Pharmacy, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
authors.forename: Justin M
authors.initials: JM
authors.lastname: Julius
authors.affiliation: 1 Division of Pharmacy, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
authors.forename: Aimee
authors.initials: A
authors.lastname: Hammerstrom
authors.affiliation: 2 Division of Biostatistics, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
authors.forename: Caimiao
authors.initials: C
authors.lastname: Wei
authors.affiliation: 3 Division of Obstetrics, Gynecology, and Reproductive Sciences, The University of Texas Health Science Center at Houston, TX, USA.
authors.forename: Raeshmma
authors.initials: R
authors.lastname: Rajesh
authors.affiliation: 4 Department of Gynecologic Oncology, Division of Surgery, The University of Texas M.D Anderson Cancer Center, Houston, TX, USA.
authors.forename: Diane C
authors.initials: DC
authors.lastname: Bodurka
authors.affiliation: 4 Department of Gynecologic Oncology, Division of Surgery, The University of Texas M.D Anderson Cancer Center, Houston, TX, USA.
authors.forename: Shiney
authors.initials: S
authors.lastname: Kurian
authors.affiliation: 3 Division of Obstetrics, Gynecology, and Reproductive Sciences, The University of Texas Health Science Center at Houston, TX, USA.|5 Department of Pharmacy, UTHealth-Memorial Hermann Cancer Center-TMC, Houston, TX.
authors.forename: Judith A
authors.initials: JA
authors.lastname: Smith
mesh_terms: D000367:Age Factors; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D064146:Chemotherapy-Induced Febrile Neutropenia / Q000453:epidemiology* / Q000517:prevention & control*; D005260:Female; D005334:Fever; D005833:Genital Neoplasms, Female / Q000188:drug therapy*; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D011994:Recombinant Proteins / Q000627:therapeutic use*; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor
keywords: Neutropenia; chemotherapy; growth factors; gynecologic cancers