Risk of febrile neutropenia in patients receiving emerging chemotherapy regimens.
Purpose: Considerable evidence exists concerning the risk of febrile neutropenia (FN) associated with well-established, older chemotherapy regimens. Little is known, however, about the risks associated with many regimens that were introduced in the past decade and have become the predominant choice...
| Publicado en: | Supportive Care in Cancer Vol. 22; no. 12; pp. 3275 - 3286 |
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| Autores principales: | , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Springer Nature
Dec2014
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103852739&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 103852739 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09414355 O1J jtl: Supportive Care in Cancer issn: 09414355 maglogo: N pubinfo: dt: Dec2014 vid: 22 iid: 12 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 103852739 NLM25082364 2012786386 10.1007/s00520-014-2362-5 NLM25082364 103852739 ppf: 3275 ppct: 11 formats: fmt: @attributes: type: P tig: atl: Risk of febrile neutropenia in patients receiving emerging chemotherapy regimens. aug: au: Weycker, Derek Li, Xiaoyan Edelsberg, John Barron, Rich Kartashov, Alex Xu, Hairong Lyman, Gary H affil: Policy Analysis Inc. (PAI), Four Davis Court, Brookline, MA, 02445, USA, dweycker@pai2.com. sug: subj: Antiinfective Agents Therapeutic Use Antineoplastic Agents Administration and Dosage Antineoplastic Agents Classification Antineoplastic Agents, Combined Adverse Effects Chemotherapy, Cancer Adverse Effects Granulocyte Colony-Stimulating Factor Therapeutic Use Neutropenia Diagnosis Neutropenia Epidemiology Neutropenia Physiopathology Febrile Neutropenia Aged Antineoplastic Agents, Combined Classification Chemoprevention Methods Female Hospitalization Statistics and Numerical Data Human Incidence Middle Age Neoplasms Classification Neoplasms Drug Therapy Neutropenia Prevention and Control Retrospective Design Risk Assessment Risk Factors United States Young Adult Aged: 65+ years Middle Aged: 45-64 years Female ab: Purpose: Considerable evidence exists concerning the risk of febrile neutropenia (FN) associated with well-established, older chemotherapy regimens. Little is known, however, about the risks associated with many regimens that were introduced in the past decade and have become the predominant choice for certain cohorts of patients or are increasingly being used in clinical practice.Methods: A retrospective cohort design and US healthcare claims data (2006-2011) were employed. Study subjects included adult patients receiving the following: docetaxel + cyclophosphamide (TC), 5-FU + epirubicin + cyclophosphamide (FEC), FEC followed by docetaxel (FEC → D), or docetaxel + carboplatin + trastuzumab (TCH) for non-metastatic breast cancer; TCH for metastatic breast cancer; 5-FU + leucovorin + irinotecan + oxaliplatin (FOLFIRINOX) for metastatic pancreatic cancer; and bendamustine (with rituximab [BR], without rituximab [B-Mono]) for non-Hodgkin's lymphoma (NHL). For each patient, the first qualifying chemotherapy course and each cycle therein were identified, as were the use of supportive care-colony-stimulating factors (CSF) and antimicrobials (AMB)-and unique FN episodes.Results: The crude risk (incidence proportion) of FN during the chemotherapy course ranged from 8.8 (95 % CI 8.3-9.3) to 10.6 % (9.3-12.1) among the breast cancer regimens, was slightly higher for the NHL regimens (BR, 10.5 % [8.9-12.4]; B-Mono, 14.7 % [11.2-18.9]), and was markedly higher for FOLFIRINOX (24.7 % [17.9-33.1]). Most patients developing FN required inpatient care (range, 73-90 %). Use of CSF primary prophylaxis ranged from 17 (B-Mono) to 75 % (FEC → D); use of AMB primary prophylaxis ranged from 6 (FOLFIRINOX) to 13 % (B-Mono).Conclusion: The risk of FN among patients receiving selected emerging chemotherapy regimens is considerable, and most cases require inpatient care. Use of CSF and AMB prophylaxis, however, varies substantially across regimens. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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