Journal articles: 'Chemotherapy-induced febrile neutropenia'

1

Temblett, Paul. "Chemotherapy-induced febrile neutropenia." Clinical Medicine 8, no. 6 (December 1, 2008): 634.1–634. http://dx.doi.org/10.7861/clinmedicine.8-6-634.

Full text

APA, Harvard, Vancouver, ISO, and other styles

2

Moe, Myat, and Robert Leonard. "Chemotherapy induced febrile neutropenia." Oncology Times 4, no. 3 (March 2007): 21. http://dx.doi.org/10.1097/01434893-200703000-00019.

Full text

APA, Harvard, Vancouver, ISO, and other styles

3

Salako, Omolola, Kehinde Sharafadeen Okunade, Adeoluwa Akeem Adeniji, Gabriel Fagbenro, and Oluwasegun Afolaranmi. "Chemotherapy-induced neutropenia among breast cancer patients presenting to a tertiary hospital in Nigeria." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): e12523-e12523. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e12523.

Full text

Abstract:

e12523 Background: Neutropenia and febrile neutropenia are major dose-limiting adverse effects of systemic cancer chemotherapy. It has been associated with significant morbidity and mortality, and high costs of management, and treatment breaks in cancer patients especially in resource-limited environments leading to poorer outcomes. Chemotherapy-induced neutropenia is an established complication of breast cancer treatment, however, there is paucity of information on the exact magnitude of the condition. This study assessed the prevalence of neutropenia and febrile neutropenia, while identifying their associated factors. Methods: A cross-sectional study was conducted among 113 female chemotherapy-naïve breast cancer patients over a two-year period. Sociodemographic, clinical and haematological data was obtained via semi-structured interviews and from medical case files. Blood samples for complete blood count parameters were collected after each course of chemotherapy. The National Cancer Institute Common Terminology CTCAE version 4.03 was used to assess febrile neutropenia, neutropenia and its severity. Results: The prevalence of neutropenia and febrile neutropenia among the patients was 31.9% and 5.3% respectively. Throughout all courses of chemotherapy, there were neutropenic episodes 11.4% (57/502) with mild neutropenia 6.6%, moderate 3.4% and severe 1.4%. Prevalence of neutropenia decreased with increasing chemotherapy courses, with prevalence after first course being 14.2% and last course 4.9%. Associated risk factors for developing neutropenia include increasing age ( p = 0.014), ECOG performance score > 1 at presentation (p = 0.033) and presence of bone metastasis (p = 0.002). Conclusions: One in three breast cancer patients developed neutropenia while on chemotherapy. The use of prophylactic G-CSF after each course of chemotherapy should be a routine practice, especially among elderly patients, unstable patients, and those with bone metastasis.

APA, Harvard, Vancouver, ISO, and other styles

4

Strojnik, Ksenija, Ksenija Mahkovic-Hergouth, Barbara Jezersek Novakovic, and Bostjan Seruga. "Outcome of severe infections in afebrile neutropenic cancer patients." Radiology and Oncology 50, no. 4 (December 1, 2016): 442–48. http://dx.doi.org/10.1515/raon-2016-0011.

Full text

Abstract:

Abstract Background In some neutropenic cancer patients fever may be absent despite microbiologically and/or clinically confirmed infection. We hypothesized that afebrile neutropenic cancer patients with severe infections have worse outcome as compared to cancer patients with febrile neutropenia. Patients and methods We retrospectively analyzed all adult cancer patients with chemotherapy-induced neutropenia and severe infection, who were admitted to the Intensive Care Unit at our cancer center between 2000 and 2011. The outcome of interest was 30-day in-hospital mortality rate. Association between the febrile status and in-hospital mortality rate was evaluated by the Fisher’s exact test. Results We identified 69 episodes of severe neutropenic infections in 65 cancer patients. Among these, 9 (13%) episodes were afebrile. Patients with afebrile neutropenic infection presented with hypotension, severe fatigue with inappetence, shaking chills, altered mental state or cough and all of them eventually deteriorated to severe sepsis or septic shock. Overall 30-day in-hospital mortality rate was 55.1%. Patients with afebrile neutropenic infection had a trend for a higher 30-day in-hospital mortality rate as compared to patients with febrile neutropenic infection (78% vs. 52%, p = 0.17). Conclusions Afebrile cancer patients with chemotherapy-induced neutropenia and severe infections might have worse outcome as compared to cancer patients with febrile neutropenia. Patients should be informed that severe neutropenic infection without fever can occasionally occur during cancer treatment with chemotherapy.

APA, Harvard, Vancouver, ISO, and other styles

5

Marshall, E., and H. Innes. "Chemotherapy induced febrile neutropenia: management and prevention." Clinical Medicine 8, no. 4 (August 1, 2008): 448–51. http://dx.doi.org/10.7861/clinmedicine.8-4-448.

Full text

APA, Harvard, Vancouver, ISO, and other styles

6

Korpelainen, Sini, Carina Intke, Sari Hämäläinen, Esa Jantunen, Auni Juutilainen, and Kari Pulkki. "Soluble CD14 as a Diagnostic and Prognostic Biomarker in Hematological Patients with Febrile Neutropenia." Disease Markers 2017 (2017): 1–8. http://dx.doi.org/10.1155/2017/9805609.

Full text

Abstract:

Objective. Elevated levels of a cell surface glycoprotein, soluble cluster of differentiation 14 (sCD14), have been observed in patients with sepsis. Only scarce data are available on sCD14 in hematological patients with chemotherapy-induced febrile neutropenia. The study aim was to investigate sCD14 as an early biomarker in febrile neutropenia after intensive chemotherapy to detect a rapidly deteriorating clinical course early enough to avoid serious infectious complications.Patients and Methods. This prospective study included 87 adult hematological patients at the start of febrile neutropenia after intensive chemotherapy for acute myeloid leukemia or after autologous stem cell transplantation. The study endpoints were septic shock, severe sepsis, and positive blood culture findings. sCD14 was analyzed from day 0 to day 2, and its prognostic capacity was compared to that of C-reactive protein and procalcitonin.Results. Plasma level of sCD14 predicted the development of septic shock on day 1 (p=0.001) and day 2 but not the development of severe sepsis or blood culture positivity in hematological patients with chemotherapy-induced febrile neutropenia.Conclusions. Soluble CD14 did not predict an overall complicated course at the early stages of febrile neutropenia. However, it was helpful in predicting the progression of the clinical course of neutropenic fever to septic shock.

APA, Harvard, Vancouver, ISO, and other styles

7

Murtaza, Hafiz Muhammad, Samra Maryam, Muhammad Shaheen Iqbal, Tariq Ghafoor, Aamir Aslam Awan, and Naeem Farid. "Chemotherapy Induced Neutropenic Fever and Its Response to Empirical Antimicrobial Therapy." Pakistan Armed Forces Medical Journal 72, SUPPL-2 (June 2, 2022): S172–77. http://dx.doi.org/10.51253/pafmj.v72isuppl-2.3079.

Full text

Abstract:

Objective: To find out the frequency of chemotherapy-induced febrile neutropenia (FN) in children diagnosed with Acute Lymphoblastic Leukemia (ALL) and its response to empirical antibiotic therapy. Study Design: Cross-sectional study. Place and Duration of Study: Department of Peadiatric Oncology, Combined Military Hospital, Rawalpindi Pakistan, from Nov 2017 to Oct 2018. Methodology: Newly diagnosed pediatric patients suffering from acute lymphoblastic leukemia between 1 to 15 years of age were included. All patients were treated with chemotherapy according to the United Kingdom National Randomized Trial for Children and Young adults with Acute Lymphoblastic Leukemia (UKALL) 2011 protocol. Patients with febrile neutropenic (FN) episodes were treated with empirical antimicrobial therapy as per hospital guidelines. Patients ‘response to antimicrobial therapy, blood culture results and related complications were noted. Results: Out of a total 77 patients, 45 (58.4%) had 69 episodes of febrile neutropenia (FN), 62 (78.5%) episodes of febrile neutropenia (FN) were started empirical treatment with first-line antibiotics (piperacillin-tazobactam and amikacin) whereas 15 (21.7%) episodes of febrile neutropenia (FN) not responding to the 1st line were shifted to second-line antibiotics (meropenem and amikacin). Mean duration of fever was 4.1 ± 2.8 days on 1st line antibiotic regimen, 2.6 ± 1 days on 2nd line antibiotics and 6.3 ± 3.3 days on combination with antifungal drug. Ten patients received antifungal therapy empirically. Efficacy of the 1st line and the 2nd line was 72.5% and 77% respectively. Staphylococcus aureus was the most frequent organism isolated from blood culture results. During the induction phase, 10 (12.9%) patients..............

APA, Harvard, Vancouver, ISO, and other styles

8

McBride, Ali, Neda Alrawashdh, Trace Bartels, Logan Moore, Daniel Persky, and Ivo Abraham. "Same-day versus next-day pegfilgrastim or pegfilgrastim-cbqv in patients with lymphoma receiving CHOP-like chemotherapy." Future Oncology 17, no. 26 (September 2021): 3485–97. http://dx.doi.org/10.2217/fon-2021-0532.

Full text

Abstract:

Aim: To compare the incidence of febrile neutropenia and related outcomes of prophylactic same-day versus next-day pegfilgrastim/pegfilgrastim-cbqv in patients with lymphoma receiving cyclophosphamide, hydroxydaunorubicin, vincristine, prednisone (CHOP)-like chemotherapy. Methods: Retrospective, real-world, single-institution study. Results: 93 patients received 460 cycles of CHOP-like chemotherapy. The incidence of febrile neutropenia and grade 3/4 chemotherapy-induced neutropenia was 5 and 16.5%, respectively. In 401 cycles pegfilgrastim was administered same-day versus 12 cycles next-day. Febrile neutropenia occurred in 17 cycles versus 0 cycles (p = 1.00) and grade 3/4 chemotherapy-induced neutropenia in 65 cycles (16.2%) versus 1 cycle (16.7%; p = 1.00) with same-day versus next-day pegfilgrastim administration, respectively. Conclusion: Pegfilgrastim may be safely administered on the same day as chemotherapy in patients with lymphoma receiving CHOP-like chemotherapy.

APA, Harvard, Vancouver, ISO, and other styles

9

Bal, Abhijit M., and Ian M. Gould. "Empirical antimicrobial treatment for chemotherapy-induced febrile neutropenia." International Journal of Antimicrobial Agents 29, no. 5 (May 2007): 501–9. http://dx.doi.org/10.1016/j.ijantimicag.2006.11.026.

Full text

APA, Harvard, Vancouver, ISO, and other styles

10

Dimitrijević, Jelena, and Marko Stojanović. "Prophylaxis and management of chemotherapy-induced febrile neutropenia: The role of myeloid growth factors." Medicinski podmladak 73, no. 2 (2022): 1–5. http://dx.doi.org/10.5937/mp73-36780.

Full text

Abstract:

Febrile neutropenia is a serious chemotherapy-related adverse event that can lead to complications and death and it could be a significant burden on the organization of the health care system. The risk for febrile neutropenia is determined by chemotherapy-induced myelosuppression and the presence of patient-related risk factors. In the literature, various patient-related risk factors are taken into consideration. It was suggested that the patient age is the one of the most important ones. If the estimated risk for the febrile neutropenia is high, prophylactic use of myeloid growth factors (granulocyte colony-stimulating factor and granulocyte-macrophage colony-stimulating factor) is recommended. In patients with solid tumors and lymphomas it was shown that the prophylactic use of myeloid growth factors significantly reduces the incidence of febrile neutropenia, early mortality during chemotherapy and infection-induced mortality. In patients who develop febrile neutropenia, there is less evidence for the therapeutic use of myeloid growth factors compared to prophylactic use, although there is a clear benefit in reducing the time to neutrophil count recovery. There is a clear benefit for hospitalized patients, also, in reducing duration of hospitalization. In patients with febrile neutropenia who have not been previously treated with prophylactic myeloid factors, assessment of risk factors for the complications is advised. In patients with high-risk febrile neutropenia therapeutic use of growth should be considered.

APA, Harvard, Vancouver, ISO, and other styles

11

Hashiguchi, Yasunori, Mari Kasai, Takeshi Fukuda, Tomoyuki Ichimura, Tomoyo Yasui, and Toshiyuki Sumi. "Chemotherapy-induced neutropenia and febrile neutropenia in patients with gynecologic malignancy." Anti-Cancer Drugs 26, no. 10 (November 2015): 1054–60. http://dx.doi.org/10.1097/cad.0000000000000279.

Full text

APA, Harvard, Vancouver, ISO, and other styles

12

Dimitrijevic, Jelena, Snezana Bosnjak, Ana Vidovic, and Marina Nikitovic. "Comprehensive evaluation of risk factors for the development and complications of chemotherapy-induced febrile neutropenia." Srpski arhiv za celokupno lekarstvo, no. 00 (2022): 54. http://dx.doi.org/10.2298/sarh211109054d.

Full text

Abstract:

Febrile neutropenia is a serious adverse effect of chemotherapy. It can lead to complications and death as well as delays in treatment, chemotherapy dose reductions, compromised treatment efficacy and reduced survival. The assessment of the patient-related risk factors plays a significant role in the prevention of febrile neutropenia and its complications. In the case of intermediate-risk chemotherapy, the patient-related factors contribute to the estimation of an overall febrile neutropenia risk as well as to timely planning of primary prophylaxis using growth factors. Patients presenting with febrile neutropenia undergo a detailed initial risk assessment for serious complications so that an appropriate treatment can be selected. Recommendations given by the guidelines outline the classification of and risk factors for febrile neutropenia complications. The usage of patient-related factors and validated tools for the risk assessment of complications makes it possible to optimize the treatment for each patient and to reduce the risk of morbidity and mortality due to FN.

APA, Harvard, Vancouver, ISO, and other styles

13

Ravaud, A., C. Chevreau, L. Cany, P. Houyau, N. Dohollou, H. Roché, P. Soubeyran, et al. "Granulocyte-macrophage colony-stimulating factor in patients with neutropenic fever is potent after low-risk but not after high-risk neutropenic chemotherapy regimens: results of a randomized phase III trial." Journal of Clinical Oncology 16, no. 9 (September 1998): 2930–36. http://dx.doi.org/10.1200/jco.1998.16.9.2930.

Full text

Abstract:

PURPOSE A randomized unblinded phase III trial was designed to determine the ability of granulocyte-macrophage colony-stimulating factor (GM-CSF) to accelerate recovery from febrile neutropenia induced by chemotherapy. PATIENTS AND METHODS A total of 68 patients with febrile neutropenia following chemotherapy defined as axillary temperature greater than 38 degrees C and absolute neutrophil count (ANC) less than 1 x 10(9)/L were included. After stratification for high- and low-risk chemotherapy to induce febrile neutropenia, treatment was randomized between GM-CSF at 5 microg/kg/d or control, both being associated with antibiotics. RESULTS GM-CSF significantly reduced the median duration of neutropenia from 6 to 3 days for ANC less than 1 x 10(9)/L(P < .001) and from 4 to 3 days for ANC less than 0.5 x 10(9)/L (P=.024), days of hospitalization required for febrile neutropenia, and duration of antibiotics during hospitalization. The greatest benefit with GM-CSF appeared for patients who had received low-risk chemotherapy, for which the median duration of ANC less than 1 x 10(9)/L was reduced from 7 to 2.5 days (P < .001) and from 4 to 2 days for ANC less than 0.5 x 10(9)/L (P=.0011), the duration of hospitalization during the study from 7 to 4 days (P=.003), and the duration on antibiotics during hospitalization from 7 to 3.5 days (P < .001). A multivariate analysis, using Cox regression, showed that variables predictive for recovery from neutropenia were GM-CSF (P=.0010) and time interval between the first day of chemotherapy and randomization (P=.030). There was no benefit for GM-CSF when high-risk chemotherapy was considered. CONCLUSION GM-CSF significantly shortened duration of neutropenia, duration of neutropenic fever-related hospitalization, and duration on antibiotics during hospitalization when febrile neutropenia occurred after low-risk chemotherapy, but not high-risk chemotherapy.

APA, Harvard, Vancouver, ISO, and other styles

14

Fontanella, Caterina, Silvia Bolzonello, Bianca Lederer, and Giuseppe Aprile. "Management of Breast Cancer Patients with Chemotherapy-Induced Neutropenia or Febrile Neutropenia." Breast Care 9, no. 4 (2014): 239–45. http://dx.doi.org/10.1159/000366466.

Full text

APA, Harvard, Vancouver, ISO, and other styles

15

Shetty, Vijith, MalonaLilly Philip, Neethu Saj, AntonyMathew Sebastian, and UdayVenkat Mateti. "Assessment of chemotherapy-induced febrile neutropenia in cancer patients." Indian Journal of Medical and Paediatric Oncology 40, no. 2 (2019): 249. http://dx.doi.org/10.4103/ijmpo.ijmpo_31_18.

Full text

APA, Harvard, Vancouver, ISO, and other styles

16

Ahn, Shin, Yoon-Seon Lee, Jae-Lyun Lee, Kyung Soo Lim, and Sung-Cheol Yoon. "A new prognostic model for chemotherapy-induced febrile neutropenia." International Journal of Clinical Oncology 21, no. 1 (June 7, 2015): 46–52. http://dx.doi.org/10.1007/s10147-015-0853-0.

Full text

APA, Harvard, Vancouver, ISO, and other styles

17

Rahman, M. Mizanur, and Mohiuddin Ahmed Khan. "Levofloxacin prophylaxis to prevent bacterial infection in chemotherapy-induced neutropenia in acute leukemia." Bangladesh Medical Research Council Bulletin 35, no. 3 (February 7, 2010): 91–94. http://dx.doi.org/10.3329/bmrcb.v35i3.4130.

Full text

Abstract:

Infection in chemotherapy-induced neutropenia (neutrophils <500/mm3) is the main cause of death during the treatment of acute leukemia. Antibiotic prophylaxis is a controversial issue to prevent or delay this infection. This study assessed the efficacy of prophylaxis with oral levofloxacin in chemotherapy-induced febrile neutropenic patients. Eighty patients of acute leukemia was randomly assigned to had levofoxacin (500 mg/daily) or placebo from the starting of chemotherapy. Out of 80 patients 53 developed neutropenia and fever. The number of patients with fever (78% vs. 68%), isolation of the pathogenic bacteria (30.43% vs. 16%) was higher and mean starting day of the fever (11.1 vs. 13.2) was shorter in the placebo group than the levofloxacin group. Levofloxacin reduced the bacterial infections and delays the onset of fever in chemotherapy-induced neutropenia especially in short duration (<7 days). Keywords: Chemotherapy; Leukemia; Levofloxacin; NeutropeniaOnline: 8 Feb 2010DOI: http://dx.doi.org/10.3329/bmrcb.v35i3.4130 Bangladesh Med Res Counc Bull 2009; 35: 91-94

APA, Harvard, Vancouver, ISO, and other styles

18

Bhosale, Bharatsinha Baburao, Vijay Patil, Vamshi Muddu, Randeep Singh, Pankaj Dwivedi, Vanita Noronha, Amit Joshi, et al. "Predicting complications of chemotherapy-induced febrile neutropenia: A single-center experience." Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): e20678-e20678. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.e20678.

Full text

Abstract:

e20678 Background: Identifying the parameters associated with increased complications would help to formulate a cost-effective and rational therapy in patients with chemotherapy induced febrile neutropenia. Methods: We prospectively collected data from January 2007-December 2011 of consecutive episodes of neutropenic fever at our centre. Clinical features, laboratory characteristics and MASCC score were analysed to identify patients at higher risk for developing complications. Complications were defined as either of the following event: failure of first line antibiotics, organ failure, delay in next cycle of chemotherapy, inpatient admission and death. Results: Three hundred and eighty-eight febrile neutropenia (FN) episodes in 373 patients were included, 256 episodes of FN in hematolymphoid malignancies and 132 episodes of FN in solid tumours. The median age was 31 years (11-76 years). Two hundred and forty-four (65.4%) patients were male. One hundred forty-nine patients (39.94%) had FN during previous cycles, while primary GCSF prophylaxis was used for 205 (52.84%) cases. The median haemoglobin, nadir neutrophil count & median number of days with severe neutropenia (< 1X109/L) were 7.9 gm/dl, 0.04X109/L and 4 days respectively. A clinical focus of infection was present in 174 (44.8%) episodes, with gastrointestinal being the commonest in 70episodes (40.23%). High risk MASCC score (<21) was present in 156 episodes (40%). Complications were seen in 133(34%) instances. On Univariate analysis, age, type of malignancy, prophylactic growth factor use, clinical focus of infection, day of FN, MASCC score, nadir Hb and platelet count were significantly associated with complications. All predictive factors except age and nadir Hb could independently predict complication on multivariate analysis. Conclusions: Clinical and laboratory parameters in addition to MASCC score could help in identifying patients with FN who require hospitalisation and more intensive management strategies.

APA, Harvard, Vancouver, ISO, and other styles

19

Ong, Seeu Si, Peh Joo Ho, Alexis Jiaying Khng, Elaine Hsuen Lim, Fuh Yong Wong, Benita Kiat-Tee Tan, Swee Ho Lim, et al. "Association between Breast Cancer Polygenic Risk Score and Chemotherapy-Induced Febrile Neutropenia: Null Results." Cancers 14, no. 11 (May 31, 2022): 2714. http://dx.doi.org/10.3390/cancers14112714.

Full text

Abstract:

Background: The hypothesis that breast cancer (BC) susceptibility variants are linked to chemotherapy-induced toxicity has been previously explored. Here, we investigated the association between a validated 313-marker-based BC polygenic risk score (PRS) and chemotherapy-induced neutropenia without fever and febrile neutropenia (FNc) in Asian BC patients. Methods: This observational case-control study of Asian BC patients treated with chemotherapy included 161 FNc patients, 219 neutropenia patients, and 936 patients who did not develop neutropenia. A continuous PRS was calculated by summing weighted risk alleles associated with overall, estrogen receptor- (ER-) positive, and ER-negative BC risk. PRS distributions neutropenia or FNc cases were compared to controls who did not develop neutropenia using two-sample t-tests. Odds ratios (OR) and corresponding 95% confidence intervals were estimated for the associations between PRS (quartiles and per standard deviation (SD) increase) and neutropenia-related outcomes compared to controls. Results: PRS distributions were not significantly different in any of the comparisons. Higher PRSoverall quartiles were negatively correlated with neutropenia or FNc. However, the associations were not statistically significant (PRS per SD increase OR neutropenia: 0.91 [0.79–1.06]; FNc: 0.87 [0.73–1.03]). No dose-dependent trend was observed for the ER-positive weighted PRS (PRSER-pos) and ER-negative weighted PRS (PRSER-neg). Conclusion: BC PRS was not strongly associated with chemotherapy-induced neutropenia or FNc.

APA, Harvard, Vancouver, ISO, and other styles

20

Alimuddin, Indrawaty, and Agussalim Bukhari. "Improving Neutrophil-to-Lymphocyte Ratio With Nutritional Therapy in Chemotherapy-Induced Febrile Neutropenia: A Case Report." Current Developments in Nutrition 5, Supplement_2 (June 2021): 838. http://dx.doi.org/10.1093/cdn/nzab047_001.

Full text

Abstract:

Abstract Objectives Febrile Neutropenia (FN) is a serious complicaton of cancer chemotherapy. About 1% of patients with cancer who receive chemotherapy develop FN, which contributes to morbidity and mortality. Neutropenia is characterized by reduced neutrophils below normal, usually occuring7 to 12 days after cancer chemotherapy, where absolute neutrophil count (ANC) of less than 500 cells per microliter in 48 hours. Neutrophil-to-Lymphocyte Ratio is an indicator of inflammatory status that can predict the outcome of FN patients. Methods A 69-year-old female patient with Moderate Malnutrition based on Subjective Global Assessment, suffered from Febrile Neutropenia. Seven months earlier she undergone the sixth cycle of chemotherapy due to Rhabdomyosarcoma, with the cyclophosphamide, vincristine, doxorubicin, dacarbazine regimen and lastly 12 days before admitted to hospital. Oral intake decreased due to shortness of breath and loss of appetite. Physical examination showed conjunctival anemia, loss of subcutaneous fat, muscle wasting. Blood tests showed anemia (Hb 7,4 g/dl), leucopenia (360/ul), thrombocytopenia (29.000/mm3), Neutrophil-to-Lymphocyte Ratio/NLR (9), hyponatremia (120 mmol/L), hypokalemia (2,5 mmol/L), hypoalbuminemia (3,0 g/dl). Handgrip dynamometer 5 kg. Results Nutritional therapy was given gradually with a target calorie 1800 kcal and protein 1,4–1,7 g/ideal body weight with regular food and parenteral nutrition. After 14 days of nutritional treatment, the patient was discharged from hospital without shortness of breath, adequate nutritional intake, improved blood test results (leucocytes 1780/ul, NLR 5,24, albumin 3,1 g/dl, Hb 8,9 g/dl, sodium 132 mmol/L, potassium 3,6 mmol/L), handgrip dynamometer 19 kg. Conclusions The success of treatment in people with chemotherapy-induced Febrile Neutropenia are influenced by the nutritional status. Febrile Neutropenia patients are in hypercatabolic conditions due to inflammatory process. Neutrophil-to-Lymphocyte Ratio (NLR) reflects an inflammatory response, which will be a predictor of outcome in solid tumors. Nutritional therapy can improve the quality of life and prognosis of chemotherapy-induced Febrile Neutropenia. Funding Sources The author (s) received no financial support for the research, authorship, and/or publication of this article.

APA, Harvard, Vancouver, ISO, and other styles

21

Al Saifi, Said Ahmed, Badriya Al Adawi, and Ikram Burney. "Patterns of Bacterial Isolates and their Resistance to Antibiotics in Patients with Chemotherapyinduced Febrile Neutropenia at a University Hospital." Oman Medical Journal 36, no. 4 (July 15, 2021): e290-e290. http://dx.doi.org/10.5001/omj.2021.87.

Full text

Abstract:

Objectives: Febrile neutropenia is a major complication of cytotoxic chemotherapy and is associated with a high rate of mortality and morbidity if not treated appropriately. Consequently, it is important to know the bacterial spectrum and pattern of its resistance in each hospital to formulate an appropriate empiric antibiotic regimen. We sought to study the bacterial spectrum in patients with chemotherapy-induced neutropenia and report their resistance patterns. Methods: We conducted a retrospective study on patients admitted with febrile neutropenia between January 2010 and December 2016 in the oncology unit at Sultan Qaboos University Hospital in Oman. Consecutive patients diagnosed with non-hematological malignancies who had febrile neutropenia and positive blood culture were included in this study. Results: A total of 76 bacterial isolates were documented in 67 episodes in 62 patients. There were 26 male and 36 female patients. The median age was 51 (14–81) years. The most common cancers were breast cancer (17.7%), non-Hodgkin lymphoma (16.1%), and colon cancer (14.5%). Gramnegative and gram-positive organisms accounted for 73.7% and 26.3% of all isolates, respectively. The most common gram-negative organisms were Pseudomonas aeruginosa (26.8%), Escherichia coli (23.2%), Klebsiella species (17.9%), and Acinetobacter baumannii (12.5%). The most common gram-positive organisms were Staphylococcus aureus (30.0%), followed by coagulase-negative Staphylococcus (25.0%). There were 14 multidrugresistant organisms and eight extended-spectrum beta-lactamases (ESBL). The resistance among gram-negative organisms to the commonly used broad-spectrum antibiotics was 23.5–55.6%. No resistance was recorded against vancomycin amongst the gram-positive organisms. Eight (12.1%) patients died while neutropenic. Conclusions: Gram-negative organisms were the predominant organisms. There is a high rate of resistance to the commonly used antibiotics. Using a combination of antibiotics is warranted in patients presenting with chemotherapy-induced febrile neutropenia.

APA, Harvard, Vancouver, ISO, and other styles

22

Tian, Huan, Wei Qin, Wenjing Wu, Pi Guo, Yong Lu, Pengxi Liu, Qiang Liu, and Fengxi Su. "Effects of Traditional Chinese Medicine on Chemotherapy-Induced Myelosuppression and Febrile Neutropenia in Breast Cancer Patients." Evidence-Based Complementary and Alternative Medicine 2015 (2015): 1–11. http://dx.doi.org/10.1155/2015/736197.

Full text

Abstract:

Title. Chemotherapy-induced myelosuppression lowers the quality of life in breast cancer patients and causes many complications. Traditional Chinese Medicine (TCM) is a widely used complementary and alternative medicine therapies.Objective. To study whether TCM can reduce the incidence of chemotherapy-induced leukopenia, neutropenia, and febrile neutropenia (FN) in breast cancer patients.Methods. The data were analyzed retrospectively between patients who received TCM treatment (group 1,n=453) and patients who did not receive TCM treatment (group 2,n=359). Significant risk factors associated with the occurrence of chemotherapy-induced leukopenia, neutropenia, and FN were identified using multivariate analysis. Propensity score-matched patients were analyzed to adjust for any baseline differences.Results. Group 1 patients had a significantly lower rate of chemotherapy-induced severe leukopenia, neutropenia, and FN, compared with group 2 (43% versus 71%,P<0.0001, 72% versus 78%,P=0.005, 6% versus 24%,P<0.0001, resp.). Multivariate analysis revealed that chemotherapy regimens containing anthracyclines combined with paclitaxel or docetaxel were the most significant predictor. Subgroup analysis indicated that TCM treatment showed benefit in relieving chemotherapy-induced leukopenia and FN in most chemotherapy regimens.Conclusions. TCM treatment could lower the risk of severe chemotherapy-induced leukopenia, neutropenia, and FN in breast cancer patients.

APA, Harvard, Vancouver, ISO, and other styles

23

Tralongo, Antonino C., Andrea Antonuzzo, Paolo Pronzato, Andrea Sbrana, Marianna Turrini, Federica Zoratto, and Marco Danova. "Management of chemotherapy-induced neutropenia in patients with cancer: 2019 guidelines of the Italian Medical Oncology Association (AIOM)." Tumori Journal 106, no. 4 (June 15, 2020): 273–80. http://dx.doi.org/10.1177/0300891620927093.

Full text

Abstract:

Neutropenia is the most frequent side effect of commercially available myelosuppressive drugs and its most significant complication is febrile neutropenia. It is associated with increased hospital admissions and higher probability of death. Prophylaxis with the administration of granulocyte colony-stimulating factor can prevent neutropenia caused by anticancer drugs. The correct administration of these drugs and the management of febrile neutropenia are extremely important in the treatment of patients with cancer.

APA, Harvard, Vancouver, ISO, and other styles

24

Krishnankutty, Binny, SH Advani, Suvarna Achreckar, and Dennis Thomas. "Granulocyte colony-stimulating factor (filgrastim) in chemotherapy-induced febrile neutropenia." Indian Journal of Medical and Paediatric Oncology 31, no. 3 (2010): 125. http://dx.doi.org/10.4103/0971-5851.73590.

Full text

APA, Harvard, Vancouver, ISO, and other styles

25

Ahn, Shin, Yoon-Seon Lee, and Jae-Lyun Lee. "Derivation of a prognostic model for chemotherapy-induced febrile neutropenia." Journal of Clinical Oncology 32, no. 15_suppl (May 20, 2014): e20624-e20624. http://dx.doi.org/10.1200/jco.2014.32.15_suppl.e20624.

Full text

APA, Harvard, Vancouver, ISO, and other styles

26

Hidaka, Takao, Masaki Fujimura, Masatoshi Sakai, and Shigeru Saito. "Macrophage Colony-stimulating Factor Prevents Febrile Neutropenia Induced by Chemotherapy." Japanese Journal of Cancer Research 92, no. 11 (November 2001): 1251–58. http://dx.doi.org/10.1111/j.1349-7006.2001.tb02147.x.

Full text

APA, Harvard, Vancouver, ISO, and other styles

27

Fourie, Samuel J., Alicia McMaster, Rashem Mothilal, and Keith I. Maart. "A Phase IV Clinical Trial of Patients with Solid Tumors Receiving Lenograstim as Primary Prophylaxis for Chemotherapy-Induced Neutropenia, in a Docetaxel-Based Regimen." Journal of Cancer Research 2014 (April 6, 2014): 1–7. http://dx.doi.org/10.1155/2014/684936.

Full text

Abstract:

Docetaxel-based chemotherapy regimens have substantially improved survival and recurrence rates for cancer patients. Safety profile of docetaxel regimens includes toxicities, particularly a high risk of neutropenia and febrile neutropenia. Granotax was a prospective, open label, multicentre, national phase IV study that evaluated the incidence and severity of neutropenia in adult patients with solid tumors being treated with a docetaxel-based regimen while receiving the GCSF lenograstim. Among the 394 enrolled patients the incidence of grade 3-4 neutropenia was 16.2% and of febrile neutropenia was 1.5%, far lower than the reported 85–100% and 30–40% incidence without G-CSFs. A total of 68 patients (17.3%) were reported to have experienced at least one grade 3-4 adverse event during the study. Two (0.5%) patients and 32 (8.1%) patients had dose delayed due to febrile neutropenia and neutropenia, respectively. Four (1.0%) patients and 32 (8.1%) patients had a dose changed due to febrile neutropenia and neutropenia, respectively. The low incidence of adverse effects and chemotherapy dose changes, delays, and withdrawals supports the use of lenograstim as effective primary prophylaxis in South African patients being treated with a docetaxel-based regimen. Furthermore, lenograstim may increase the patient’s exposure to chemotherapy allowing patients to receive optimal dosing and duration of treatment, benefitting survival.

APA, Harvard, Vancouver, ISO, and other styles

28

Adiwinata, Randy, Andrea Livina, Harlinda Haroen, Linda Rotty, Paul N. Harijanto, Agung Nugroho, Cecilia Hendratta, Pearla Lasut, and Christian Kawengian. "Adverse Cutaneous Drug Reaction Following Granulocyte Colony-Stimulating Factor Administration in Nasopharynx Cancer Patient with Febrile Neutropenia: A Case Report." Indonesian Journal of Cancer 16, no. 3 (September 29, 2022): 189. http://dx.doi.org/10.33371/ijoc.v16i3.878.

Full text

Abstract:

Introduction: Several side effects may occur during cancer treatment such as myelosuppression following systemic chemotherapy, which is mainly manifested as neutropenia and is associated with increased infection risk. Febrile neutropenia is associated with a worse prognosis. Granulocyte colony-stimulating factor (G-CSF) may be given prophylactically before chemotherapy in selected cases or as adjuvant therapy in febrile neutropenia. G-CSF administration may be associated with several side effects, including skin manifestation. More rarely, G-CSF administration may induce acute febrile neutrophilic dermatosis is which known as a Sweet syndrome. Case Presentation: A 63-year-old man with nasopharyngeal cancer stage III on chemotherapy and radiotherapy came to our emergency department with a chief complaint of fever, coughing, and shortness of breath. He was diagnosed with community-acquired pneumonia and febrile neutropenia. His white blood cell (WBC) count was 200/mm3 . On the third day of hospitalization and G-CSF administration, he developed a rash and had skin desquamation mainly on his head including the scalp, face, lips, upper trunk, arms, and the surface of both hands. His follow-up laboratory result was WBC 8300/mm3 with a neutrophil count of 87%. Presumable Sweet syndrome diagnosis with differential diagnosis of other drug eruption reactions was made. Systemic and topical were administered, and G-CSF was stopped. Significant improvement was observed. Conclusions: G-CSF administration in febrile neutropenic cancer is generally safe; however, several adverse events may occur. Cutaneous adverse events following G-CSF administration should be recognized and treated accordingly. Sweet syndrome is rare but should be recognized as a possible G-CSF-induced drug skin complication.

APA, Harvard, Vancouver, ISO, and other styles

29

Neesanun, Sunee. "Risk Factors Predicting Chemotherapy-induced Severe Neutropenia and Outcome in Advanced Stage Non-small Cell Lung Cancer: Data from the Limited Resource in Thailand." Asian Pacific Journal of Cancer Care 7, no. 2 (June 22, 2022): 285–93. http://dx.doi.org/10.31557/apjcc.2022.7.2.285-293.

Full text

Abstract:

Introduction: Chemotherapy-induced severe neutropenia requires dose reduction, delay in treatment, or discontinuation, and induces neutropenic complications resulting in poor outcomes and increased healthcare costs. This study aims to identify the risk factors for chemotherapy-induced severe neutropenia and outcome in advanced-stage NSCLC. Method: From July 2014-January 2019, advanced-stage NSCLC who received chemotherapy were retrospectively analyzed. Demographic and risk factors data were collected from the electronic medical record system. Univariate and multivariate logistic regression analyses were performed to identify risk factors for severe neutropenia. Survival curves were estimated using the Kaplan–Meier method. Results: Among 259 patients, 37 (14.28%) and 3 patients (1.2%) developed severe neutropenia and febrile neutropenia respectively. In multivariate analysis, restriction of protein diet (OR 9.54; 95%CI 2.44-37.24; P=0.001), concomitant use herbal medicine (OR 8.66; 95% CI 1.04-72.07; P=0.045), high BMI (OR3.1; 95% CI 1.07-8.99; P=0.04), renal disease (OR 3.9; 95% CI 1.7-8.91; P=0.001), number of cycle chemotherapy > 4 (OR 3.97; 95% CI 1.11-14.18; P=0.03) were significant predictors of Chemotherapy-induced severe neutropenia. No difference in response rate, progression-free survival and overall survival among groups (RR 18.9% vs 26.7%; median PFS; 9.6 vs 8.2 months, P=0.32 and median OS 13.8 vs 16.7 months, P=0.79 in severe and non-severe neutropenia respectively).Conclusions: The present study indicates that protein-restricted diet, concomitant use of herbal medicine, BMI ≥ 25 kg/m2, renal disease, and more than 4 cycles of chemotherapy are significant risk factors for chemotherapy-induced severe neutropenia. Therefore, patients with these risk factors should be more carefully monitored.

APA, Harvard, Vancouver, ISO, and other styles

30

Díaz Ramírez, Karla, Daniel Ortiz Morales, and Marta Zapata Tarres. "Risk factors associated to infectious complications in children with febrile neutropenia induced by chemotherapy: A cohort study." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): e22535-e22535. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e22535.

Full text

Abstract:

e22535 Background: Children cancer is the second cause of mortality, most of deaths are related to infectious complications due to immunosuppression provoked by chemotherapy. Febrile neutropenia is one of the most common issues in oncological patients and it’s considered an emergency. Studies have tried risk predicting models implementation, although they still need to be validated, updated and reproducible in different scenarios. The aim of this study was the early identification of conditioning factors to severe infectious complications in patients with febrile neutropenia that would allow taking decisions for diagnosis and treatment. Methods: We present a prospective cohort study that estimated the risk associated to clinical and paraclinical factors and the development of infectious complications in pediatric patients with febrile neutropenia induced by chemotherapy on their admission of an emergency room (ER). The clinical features analyzed were: age, type of cancer, chemotherapy regime, time between chemotherapy administration and ER admission, use of colony-stimulating factors, presence of central venous catheter, highest temperature registered, tachycardia, polypnea, hypoxemia and hypotension. The paraclinical features included were leucocyte, neutrophil and monocyte count, and C-reactive protein levels. Results: From 186 febrile neutropenia events, 101 cases reported infectious complications (54%). Clinical infection was the most frequent issue (38%). On the multivariate analysis we found that the features independently associated to infectious complication were tachycardia (OR1.07, CI95% 1.70-6.99) and highest temperature level reported in the ER (OR1.07, CI95% 1.00-1.13). Conclusions: Febrile neutropenia is the most common complication in pediatric oncological patients and it is related to life-threatening infections and high mortality rate. Risk prediction during the initial assessment in the ER is important to stratify patients and offer target therapy to decrease complications and prolonged hospitalization.

APA, Harvard, Vancouver, ISO, and other styles

31

Bond, T. Christopher, Erika Szabo, Susan Gabriel, Jean Klastersky, Omar Tomey, Udo Mueller, Lee Schwartzberg, and Boxiong Tang. "Meta-analysis and indirect treatment comparison of lipegfilgrastim with pegfilgrastim and filgrastim for the reduction of chemotherapy-induced neutropenia-related events." Journal of Oncology Pharmacy Practice 24, no. 6 (June 14, 2017): 412–23. http://dx.doi.org/10.1177/1078155217714859.

Full text

Abstract:

Background Granulocyte colony-stimulating factors are effective at reducing the risk and duration of neutropenia. The current meta-analysis compared the neutropenia-related efficacy and safety of lipegfilgrastim to those of pegfilgrastim and filgrastim. Methods Embase was searched for trials examining the efficacy/safety of lipegfilgrastim, pegfilgrastim, or filgrastim. Outcomes included febrile neutropenia, severe neutropenia, duration of severe neutropenia, time to recovery of absolute neutrophil count, and incidence of bone pain. Direct comparisons were made using random-effects models. No trials directly compared lipegfilgrastim and filgrastim. Indirect comparisons were made between lipegfilgrastim and filgrastim with pegfilgrastim as the common comparator. Results This meta-analysis included a total of 5769 patients from 24 studies. Over all cycles, lipegfilgrastim showed a lower, nonsignificant risk of febrile neutropenia compared with pegfilgrastim. Lipegfilgrastim has a lower risk of febrile neutropenia versus filgrastim but was also not statistically significant. The risk ratio for severe neutropenia in cycle 1 was 0.80, a 20% reduction in favor of lipegfilgrastim. For cycles 2–4, the risk ratio was 0.53 (0.35, 0.79) for lipegfilgrastim versus pegfilgrastim. The risk of severe neutropenia in cycles 2–4 was also significantly lower for lipegfilgrastim (risk ratio 0.45, 0.27, 0.75, respectively). No significant differences were found for febrile neutropenia and severe neutropenia in cycle 1. However, in cycles 2–4, lipegfilgrastim was associated with significant and clinically meaningful reductions in risk of severe neutropenia versus either pegfilgrastim or filgrastim. Conclusions Compared with pegfilgrastim or filgrastim, lipegfilgrastim has a statistically significantly lower absolute neutrophil count recovery time; however, differences in duration of severe neutropenia and bone pain were nonsignificant.

APA, Harvard, Vancouver, ISO, and other styles

32

Teofili, Luciana, Immacolata Izzi, Eugenia Rosa Nuzzolo, Giancarlo Scoppettuolo, Katleen De Gaetano Donati, Lorenza Torti, and Marianna Rossi. "CHEMOTHERAPY-INDUCED NEUTROPENIA IN HIV POSITIVE PATIENTS WITH LYMPHOMA: COMPARISON OF PEGFILGRASTIM WITH DAILY FILGRASTIM ADMINISTRATION." Mediterranean Journal of Hematology and Infectious Diseases 4, no. 1 (October 3, 2012): e2012062. http://dx.doi.org/10.4084/mjhid.2012.062.

Full text

Abstract:

We retrospectively compared the incidence of neutropenia in two groups of HIV patients with lymphoma, who underwent chemotherapy supported by once-per-cycle administration of pegfilgrastim or by daily subcutaneous injection of filgrastim, respectively. Our findings indicate that pegfilgrastim and filgastrim produce similar results in preventing both neutropenia and febrile neutropenia.

APA, Harvard, Vancouver, ISO, and other styles

33

Link, Hartmut. "Hematopoietic Growth Factors in the Management of Anemia and Febrile Neutropenia." Breast Care 14, no. 2 (2019): 93–98. http://dx.doi.org/10.1159/000497408.

Full text

Abstract:

Chemotherapy-induced anemia (CIA) in cancer patients correlates with poor performance status and decreased quality of life. Currently recommended causal therapies are erythropoiesis-stimulating agents (epoetins), iron substitution, or a combination of both. Guidelines recommend considering red blood cell (RBC) transfusions for symptomatic anemia at a hemoglobin (Hb) level of <8 g/dl. Granulocyte colony-stimulating factor (G-CSF) is recommended if the risk of febrile neutropenia (FN) following from the chosen chemotherapy protocol is ≥20%. If a chemotherapy is planned that induces a moderate FN risk (10-20%), the individual overall FN risk should be assessed prior to each chemotherapy cycle, taking into account patient- or tumor-related risk factors. G-CSF is required when risk factors such as age ≥ 65 years, advanced disease or relevant comorbidity, or previous neutropenia complications are present. Neutropenia that required a shift in chemotherapy is also an indication for G-CSF prophylaxis in subsequent cycles, in order to maintain the planned dose intensity. The use of G-CSF improves patient survival and reduces the rate of neutropenia complications.

APA, Harvard, Vancouver, ISO, and other styles

34

Liutkauskienė, Sigita, Audrius Sveikata, Elona Juozaitytė, Dainius Characiejus, Edita Juodžbalienė, Rima Kregždytė, and Vidmantas Fokas. "Safety and efficacy study of the recombinant granulocyte colony-stimulating factor for prevention of neutropenia and neutropenia-related complications in women with metastatic breast cancer receiving docetaxel/doxorubicin." Medicina 45, no. 8 (August 11, 2009): 600. http://dx.doi.org/10.3390/medicina45080078.

Full text

Abstract:

Background. We evaluated efficacy and safety of recombinant granulocyte-colony stimulating factor (rGCSF) used as primary prophylaxis to prevent neutropenia and neutropenia-related complications induced by docetaxel and doxorubicin chemotherapy in patients with metastatic breast cancer. Patients and methods. Three centers in Lithuania enrolled 36 patients who received rGCSF (5 μg/kg/d) on day 2 of each 21-day chemotherapy with docetaxel 75 mg/m2 and doxorubicin 50 mg/m2 (AT) starting in the first cycle. Treatment regimen was repeated for up to six cycles. Results. Leukocytosis, bone pain, and headache were the most frequent adverse events, with incidence rates of 22%, 19%, and 8%, respectively. Adverse events were typical for rGCSF in this patient population. Overall incidence rate of febrile neutropenia was 14%. The mean duration of febrile neutropenia episodes across cycles was 2.14 days. Incidence of chemotherapy delay was 2%. There was no reduction in chemotherapy dose due to expected toxicity or side effects. Intravenous antibiotics for the treatment of febrile neutropenia were needed in 19% of cases. Quality-of-life assessment shows a significant improvement in emotional functioning and a significant decrease in pain score. The efficacy profile of rGCSF observed in the present study was comparable with that of other rGCSF products previously described in the published scientific literature. Conclusions. The primary prophylaxis of neutropenia and its complications by rGCSF was safe and effective for women with metastatic breast cancer who received chemotherapy with docetaxel and doxorubicin.

APA, Harvard, Vancouver, ISO, and other styles

35

Choi, Chul Won, Hwa Jung Sung, Kyong Hwa Park, So Young Yoon, Seok Jin Kim, Sang Cheul Oh, Jae Hong Seo, et al. "Early lymphopenia as a risk factor for chemotherapy-induced febrile neutropenia." American Journal of Hematology 73, no. 4 (July 18, 2003): 263–66. http://dx.doi.org/10.1002/ajh.10363.

Full text

APA, Harvard, Vancouver, ISO, and other styles

36

Gac, Anne-Claire, Jean-Jacques Parienti, Sylvain Chantepie, Roland Leclercq, and Oumedaly Reman. "Dynamics of Procalcitonin and Bacteremia In Adult Acute Myeloid Leukemia with Chemotherapy-Induced Neutropenia." Blood 116, no. 21 (November 19, 2010): 4378. http://dx.doi.org/10.1182/blood.v116.21.4378.4378.

Full text

Abstract:

Abstract Abstract 4378 Sensitive markers of infection are rare or of limited validity in neutropenic patients. Procalcitonin (PCT), a precursor protein of calcitonin, is a specific and sensitive marker of severe bacterial infections during short-term neutropenia. Because the value of PCT measurements among patients undergoing long periods of neutropenia remains uncertain and because several mechanisms, such as bacterial or fungal infections, reactions to drugs or blood products or tumor-associated events, can cause fever, we described the dynamics of PCT in 29 acute myeloid leukemia (AML) patients with 39 instances of chemotherapy-induced neutropenia. Plasma levels of PCT were determined prospectively by an immunoluminometric assay every four days starting at the onset of chemotherapy and continuing until the resolution of fever. We found that bacteremia did increase PCT levels above 0.5 ng/mL and these levels predicted bacteremia at day 15 of chemotherapy. This finding may be relevant in the decision to alter antibiotic regimens to decrease toxicity and cost when patients remain febrile at day 15. Disclosures: No relevant conflicts of interest to declare.

APA, Harvard, Vancouver, ISO, and other styles

37

Ahmad, Alia, Fauzia Shafi Khan, Wasila Shamim, and Aman Salman Ahmad. "Burden of febrile neutropenia in paediatric oncology: Experience from Children’s Hospital Lahore Pakistan." Journal of Fatima Jinnah Medical University - 14, no. 4 (February 24, 2021): 166–69. http://dx.doi.org/10.37018/zptb7901.

Full text

Abstract:

Background: Infection is the major cause of morbidity and mortality in children with cancer. Chemotherapy induced febrile neutropenia-associated mortality is much higher in low-middle-income countries than in high-income countries, emphasizing the need of prevention, early identification and timely management of infection related complications in these children. Objective of this prospective study was to analyze the burden of chemotherapy induced febrile neutropenia and to assess the leading risk factors. Patients and methods: Prospective cohort study was done in 100 patients with febrile neutropenia (fever of 38.3℃ and ANC <500) admitted in the Haematology/Oncology Department of Children’s Hospital Lahore (CHL) from July to August 2016. All the children on curative chemotherapy were included in this study and children with relapse and on palliation were excluded from this study. Risk factors including knowledge of parents and caregivers about febrile neutropenia, travel time from home to hospital and duration of symptoms at home before seeking treatment and reasons for delayed response in these children’s febrile illness, were analyzed for duration of hospital stay considered as a burden on the Haematology/Oncology Department. Data regarding their age, sex, and clinical features, baseline CBC, course of therapy, hospital stay and understanding of caregivers regarding febrile neutropenia was analyzed. The first line therapy was IV Piperacillin-Tazobactam and IV Amikacin. SPSS-16 software was used to analyze the data and a p-value of <0.05 was considered as statistically significant. Results: Total 100 patients with age ranging from <1 to 15 years were included. Male to female ratio was 1.7:1, 72% of the cases had Acute Lymphoblastic Leukaemia and 28% with solid tumors. About, 28% had last chemotherapy received in 72 hours, 30% in last week and rest in more than a week time 36% had upper respiratory tract infections, 18% gastrointestinal infections, 20% mucositis, 10% no focus found and rest 16% had other manifestations. Only 2 % presented in less than one hour of start of symptoms, 27% <24 hours, 61% in <5 days and 10% >5 days duration of symptoms. 45% had Hb <8 gm/dL, 33% had platelets <50,000 mm3, and 54% had WBC <1000 and 63% had ANC <100. 29% presented with the first episode while 51% had 3 or more febrile neutropenia episodes. 28% cases stayed 1 hour distance from CHL while 72% had to travel >1-5 hours to reach the primary treatment center. 66% received paracetamol at home, 17 had oral antibiotics while 17% had no treatment before reaching hospital. Only 19% caregivers had adequate awareness regarding adequate management of febrile neutropenia, 72% had some understanding while 9% had no knowledge about febrile neutropenia. 46% had financial issues, 41% were unaware while, 13% showed negligence in seeking treatment. Only 2 patients stayed for a day, 46% stayed for 5 days and 48% for more than 5 days. Conclusion: Febrile neutropenia episodes accounted for 25% of monthly admissions of the Haematology/Oncology Department of Children’s Hospital Lahore. Majority of these caregivers had inadequate basic knowledge of standard management of febrile neutropenia aggravated by increased travel time from their homes to the hospital.

APA, Harvard, Vancouver, ISO, and other styles

38

Weycker, Derek, Xiaoyan Li, John Edelsberg, Rich Barron, Alex Kartashov, Hairong Xu, and Gary H. Lyman. "Risk and Consequences of Chemotherapy-Induced Febrile Neutropenia in Patients With Metastatic Solid Tumors." Journal of Oncology Practice 11, no. 1 (January 2015): 47–54. http://dx.doi.org/10.1200/jop.2014.001492.

Full text

Abstract:

Among patients receiving myelosuppressive chemotherapy for metastatic cancer in US clinical practice, febrile neutropenia is a frequent complication associated with morbidity, mortality, and economic costs.

APA, Harvard, Vancouver, ISO, and other styles

39

Laverdière, Michel, Eric J. Bow, Coleman Rotstein, Stratis Ioannou, Danielle Carr, Narguess Moghaddam, and the Canadian Fluconazole Study Group. "Antimicrobial Regimens Prescribed by Canadian Physicians for Chemotherapy-Induced Febrile Neutropenic Episodes." Canadian Journal of Infectious Diseases 10, no. 5 (1999): 353–57. http://dx.doi.org/10.1155/1999/721790.

Full text

Abstract:

OBJECTIVE: To study the antimicrobial management of cancer patients with chemotherapy-induced neutropenia by Canadian physicians.SETTING: A cohort of 274 cancer patients with severe neutropenia (ie, less than 0.5×109neutrophils/L) who participated in a prospective double-blind, placebo controlled study on antifungal prophylaxis conducted in 14 Canadian university-affiliated centres. Antifungal prophylaxis (oral fluconazole 400 mg daily) was administered to 153 of 274 (56%) patients.RESULTS: Antibacterial prophylaxis with a quinolone was given to 87 patients (32%) at the onset of chemotherapy whereas trimethoprim/sulphamethoxazole was given to 56 (20%) patients. Fever (ie, 38°C or over) occurred in 216 (79%) patients after a median duration of neutropenia of four days (range one to 31 days). Empirical antibacterial antibiotics were administered in 214 febrile patients. In 164 (77%) patients antibiotics were started during the first 24 h of fever. Monotherapy with a third generation cephalosporin and duotherapy with a antipseudomonal beta-lactam and an aminoglycoside were prescribed in 69 (32%) and 61 (28%) of the febrile patients, respectively. Inclusion of vancomycin in the initial empirical regimen was noted in 32 (15%) patients. Modifications of the initial regimen occurred in 187 (87%) patients after a median of five days (range one to 28 days). Empirical systemic amphotericin B was added after a median duration of nine days (range one to 34 days) of the empirical antibacterial regimen.CONCLUSIONS: Overall, the antimicrobial management of cancer patients with chemotherapy-induced neutropenia by Canadian physicians follows the current guidelines promulgated by the Infectious Diseases Society of America.

APA, Harvard, Vancouver, ISO, and other styles

40

Gasparini, Giampietro, Salvatore Turnolo, Giuseppe Toffoli, Renato Talamini, Alberto Vaglia, and Marco Benedetti. "Combination Antibiotic Treatment of Chemotherapy-Induced Neutropenia in Non-Leukemic Patients." Tumori Journal 75, no. 5 (October 1989): 443–48. http://dx.doi.org/10.1177/030089168907500508.

Full text

Abstract:

The use of more aggressive chemotherapies in the treatment of patients with some tumors has caused a higher frequency of neutropenia and subsequent serious infections. To verify the role in these patients of a combination therapy of amikacin (300 mg/m2 i.v. every 12 hours) plus ceftazidime (2 g/m2 i.v. every 8 hours) adminsitered as initial empiric treatment, followed in non-responsive cases by a second-line therapy with clindamycin (300 mg/m2 i.v. every 8 hours), we conducted a prospective study in 45 febrile episodes (temperature ≥38.5 °C) in neutropenic patients (neutrophils ≤500/ml). The patients' median age was 58 (range, 19-80); 29 were women and 16 were men. The median performance status was 50 (range, 30-90), and 71 % of the patients had progressive tumoral disease. Before antibiotic therapy the median duration of fever was 12 hours (range, 4-48 hours). The median granulocyte count was 350/ml (range, 100-500 cells/ml), and the median peak temperature was 38.8 °C (range, 38.5-41 °C). The median time for neutrophils to rise towards 1000/ml was 4 days (range, 2-12), and the median duration of therapy was 8 days (range, 3-12). Documented bacterial infections were present in 28 patients whereas 17 had clinically possible infections or fever of unknown origin. The infection sites in microbiologically documented infections were: septicemia (12), multiple sites (4), tonsillitis (4), urinary tract (4), pneumonia (2) and fistula (2). Complete response to first-line therapy was obtained in 36 out of 45 episodes (80 %; 95 % confidence limits from 65 % to 90 %). Five out of 8 cases responded to second-line therapy with clindamycin for an overall recovery rate of 91 %. The amikacin-ceftazidime combination followed by clindamycin in non-responsive cases is effective, with moderate toxicity in non-leukemic febrile neutropenic patients.

APA, Harvard, Vancouver, ISO, and other styles

41

_, _. "Myeloid Growth Factors Guidelines." Journal of the National Comprehensive Cancer Network 5, no. 2 (February 2007): 188. http://dx.doi.org/10.6004/jnccn.2007.0019.

Full text

Abstract:

Chemotherapy-induced neutropenia can cause complications that result in dose reductions or treatment delays that can, in turn, compromise clinical outcomes. Although the prophylactic use of colony-stimulating factors (CSFs) can reduce the risk, severity, and duration of severe and febrile neutropenia, they are not routinely administered to all patients undergoing myelosuppressive chemotherapy because of the costs. Selective use may, however, enhance their cost-effectiveness. These guidelines discuss the preventative or prophylactic use of recombinant human granulocyte-CSF to reduce the incidence, length, and severity of chemotherapy-related neutropenia and and prevent life-threatening complications. For the most recent version of the guidelines, please visit NCCN.org

APA, Harvard, Vancouver, ISO, and other styles

42

da Silva Dias, David, Catarina Jorge, Mafalda Baptista, Ana Júlia Arede, Paulo Luz, Tânia Madureira, and Beatriz Gosalbez. "BPI19-010: Febrile Neutropenia Induced by Chemotherapy: Impact of Risk Re-Stratification." Journal of the National Comprehensive Cancer Network 17, no. 3.5 (March 8, 2019): BPI19–010. http://dx.doi.org/10.6004/jnccn.2018.7207.

Full text

Abstract:

Introduction: Febrile neutropenia (FN) induced by chemotherapy (ChT) arises until 6 weeks after the last cycle, usually between 5 and 10 days post-ChT. Infection risk is 20%–30%. It is difficult to stratify patients with low risk of complications due to FN. MASCC index is useful but has limitations. This correlates with unnecessary hospital admissions, complications, and costs. Methods: Retrospective study of patients with diagnosis of FN induced by ChT, admitted to our center between 2012 and 2016. Primary goal was to describe this population. Secondary goal was to re-stratify the risk of FN using MASCC and CISNE indexes, clinical judgement, and social/logistic factors. SPSS v23 was used for statistical analysis. Results: 211 patients were included; median age, 66 years. Median hospital stay was 6 days (1–89). 25% were nosocomial admissions. At admission 46% of patients presented with stage IV cancer. 75% were solid neoplasms and 25% were hematologic. Profound neutropenia was observed in 43% and severe neutropenia in 36%. Overall mortality rate was 13%. Sepsis was diagnosed in 24 patients (11%), with a mortality rate of 54%. Only 12.3% of patients had prophylaxis with granulocyte-colony stimulating factor. At admission, 64% of patients had no obvious focal infection; 20% had probable focus; and in 16% a microorganism was identified, most commonly gram-negative Enterobacteriaceae. Most used antibiotics were piperacillin/tazobactam (44%) and its combination with aminoglycoside (34%). This combination showed benefit against some extended-spectrum beta-lactamase (ESBL)–producing strains and multiresistant (MR) Pseudomonas aeruginosa (2.8%). MASCC index identified 31% of patients with low risk FN. After applying the CISNE index, clinical judgement, and social/logistic factors, only 11% were identified as low-risk FN and did not benefit from admission. This translates to an avoidable cost of €48,000 according to the center’s annual report. Conclusion: The combination of β-lactam and aminoglycoside is overused in our practice. It is not recommended in hemodynamically stable patients and contradictory in unstable ones; still it shows some effect versus MR and ESBL strains. A study to evaluate their incidence in our center is now in progress. Low risk FN was observed in 11% of admitted patients. Our center has an internal protocol and has been able to provide a good overall response.

APA, Harvard, Vancouver, ISO, and other styles

43

Procopio, Giuseppe, Monica Niger, and Isabella Testa. "Lecture: management of chemotherapy-induced febrile neutropenia; guidelines and colony stimulating factors." Neurological Sciences 32, S2 (October 15, 2011): 217–19. http://dx.doi.org/10.1007/s10072-011-0795-x.

Full text

APA, Harvard, Vancouver, ISO, and other styles

44

Ko, Byuk Sung, Shin Ahn, Yoon-Seon Lee, Won Young Kim, Kyung Soo Lim, and Jae-Lyun Lee. "Impact of time to antibiotics on outcomes of chemotherapy-induced febrile neutropenia." Supportive Care in Cancer 23, no. 9 (February 10, 2015): 2799–804. http://dx.doi.org/10.1007/s00520-015-2645-5.

Full text

APA, Harvard, Vancouver, ISO, and other styles

45

Wong, Michelle, Babilonia Barqasho, Lars Öhrmalm, Thomas Tolfvenstam, and Piotr Nowak. "Microbial Translocation Contribute to Febrile Episodes in Adults with Chemotherapy-Induced Neutropenia." PLoS ONE 8, no. 7 (July 16, 2013): e68056. http://dx.doi.org/10.1371/journal.pone.0068056.

Full text

APA, Harvard, Vancouver, ISO, and other styles

46

Chao, Chun, John H. Page, Roberto Rodriguez, Su-Jau Yang, Julie Huynh, and Victoria M. Chia. "Chronic Comorbidities and Chemotherapy-Induced Febrile Neutropenia in Patients with Non-Hodgkin Lymphoma." Blood 120, no. 21 (November 16, 2012): 3671. http://dx.doi.org/10.1182/blood.v120.21.3671.3671.

Full text

Abstract:

Abstract Abstract 3671 Background: Chemotherapy induced febrile neutropenia (FN) is a clinically important adverse event as it can impact patient survival by delaying or reducing chemotherapy dose administered. Clinical guidelines recommend granulocyte-colony stimulating factors (G-CSF) be used in cancer patients when febrile neutropenia (FN) risk is >20%. Although the myelotoxicity of the chemotherapy regimen is a key determinant of FN risk, it is now recognized that patient characteristics may increase this risk further. We conducted a retrospective cohort study to evaluate the association of chronic comorbidities to FN in patients with non-Hodgkin lymphoma (NHL). Methods: Incident NHL cases diagnosed between 2000–2009 who received chemotherapy within 12 months of cancer diagnosis were identified from Kaiser Permanente Southern California, a large managed care organization. Those who had prophylactic G-CSFs, dose-dense chemotherapy or bone marrow transplant were excluded. Comorbidities of interest included cardiovascular, liver, renal, metabolic and autoimmune disorders, anemia, previous cancer and HIV infection. History of comorbidity of interest were assessed in the 12 months prior to NHL diagnosis, and identified by ICD-9 codes or disease registries. FN was assessed only in the first chemotherapy cycle, and identified by absolute neutrophil count (ANC), ICD-9 codes for neutropenia and fever, or hospitalization with bacterial/fungal infection. Patients were followed from their first chemotherapy treatment to the start of the second cycle, death or day 28, whichever came first. Logistic regression was used to estimate the propensity score for each comorbidity; these propensity scores included patient characteristics and other comorbidities as covariates. Each comorbidity and propensity score were included in Cox models to determine associations between comorbidities and FN. We also evaluated models that additionally adjusted for cancer stage, baseline ANC, chemotherapy regimen, dose reduction, and radiation treatment prior to chemotherapy. Results: A total of 2,480 NHL patients who received chemotherapy were included. The mean age was 63.3 years. Fifty-five percent of the cases were male, and the majority of the cases were of white race (65.6%). Sixty percent of the cases received CHOP or R-CHOP. There were 236 (9.5%) patients that had FN in the first chemotherapy cycle. Anemia [adjusted hazard ratio adjusted (HR) =1.6, 95% CI, 1.2–2.2], HIV infection [HR=3.0, 95% CI 1.6–5.3], AIDS [HR=2.4, 95% CI 1.2–4.6], and rheumatoid diseases [HR=2.1, 95% CI 1.2–3.6] were all associated with a statistically significantly increased FN risk (Table 1). In addition, peptic ulcer disease, renal disease and connective tissue disease were also associated with risk of FN, although these associations were not statistically significant. HR estimates did not change materially after also adjusting for cancer stage, ANC, chemotherapy regimen, dose reduction and radiation therapy prior to chemotherapy in the Cox model. Conclusions: Our findings suggest that several chronic comorbidities may be associated with increased FN risk in the first chemotherapy cycle among NHL patients not already receiving prophylactic G-CSFs. This information, if confirmed by others, may aid clinical decision making with respect to use of prophylactic G-CSF use during chemotherapy treatment. Disclosures: Chao: Amgen,Inc: Research Funding. Page:Amgen, Inc: Employment, Shareholder Other. Rodriguez:Amgen, Inc: Research Funding. Yang:Amgen, Inc: Research Funding. Huynh:Amgen, Inc: Research Funding. Chia:Amgen, Inc: Employment, Shareholder Other.

APA, Harvard, Vancouver, ISO, and other styles

47

Lyman, Gary H. "Guidelines of the National Comprehensive Cancer Network on the Use of Myeloid Growth Factors with Cancer Chemotherapy: A Review of the Evidence." Journal of the National Comprehensive Cancer Network 3, no. 4 (July 2005): 557–71. http://dx.doi.org/10.6004/jnccn.2005.0031.

Full text

Abstract:

The prophylactic use of myeloid growth factors reduces the risk of chemotherapy-induced neutropenia and its complications, including febrile neutropenia and infection-related mortality. Perhaps most importantly, the prophylactic use of colony-stimulating factors (CSFs) has been shown to reduce the need for chemotherapy dose reductions and delays that may limit chemotherapy dose intensity, thereby increasing the potential for prolonged disease-free and overall survival in the curative setting. National surveys have shown that the majority of patients with potentially curable breast cancer or non-Hodgkin's lymphoma (NHL) do not receive prophylactic CSF support. In this issue, the National Comprehensive Cancer Network presents guidelines for the use of myeloid growth factors in patients with cancer. These guidelines recommend a balanced clinical evaluation of the potential benefits and harms associated with chemotherapy to define the treatment intention, followed by a careful assessment of the individual patient's risk for febrile neutropenia and its complications. The decision to use prophylactic CSFs is then based on the patient's risk and potential benefit from such treatment. The routine prophylactic use of CSFs in patients receiving systemic chemotherapy is recommended in patients at high risk (>20%) of developing febrile neutropenia or related complications that may compromise treatment. Where compelling clinical indications are absent, the potential for CSF prophylaxis to reduce or offset costs by preventing hospitalization for FN should be considered. The clinical, economic, and quality of life data in support of these recommendations are reviewed, and important areas of ongoing research are highlighted.

APA, Harvard, Vancouver, ISO, and other styles

48

Saeed, Audai Nader, and Nijmeh Al-Atiyyat. "PERSPECTIVE INTERNATIONALE Gestion de la neutropénie fébrile induite par la chimiothérapie parmi des patients adultes en oncologie : recension de la documentation scientifique." Canadian Oncology Nursing Journal 25, no. 3 (2015): 285–88. http://dx.doi.org/10.5737/23688076253285288.

Full text

APA, Harvard, Vancouver, ISO, and other styles

49

Sampagar, Abhilasha, B. R. Ritesh, Dubey Shiv, Shridhar C. Ghagne, Neha Patil, and Prathamesh Pawashe. "Retrospective Analysis of Bacterial Isolates during Blood Stream Infections in Children with Chemotherapy-induced Febrile Neutropenia: A Single Centre Experience." Indian Journal of Medical and Paediatric Oncology 42, no. 06 (December 2021): 540–46. http://dx.doi.org/10.1055/s-0041-1740313.

Full text

Abstract:

Abstract Introduction The recent advances in cancer treatment have resulted in significant improvement in the outcome of pediatric cancers. However, febrile neutropenia (FN) is the most important cause of mortality and morbidity in pediatric cancer patients and is a crucial limiting factor for the outcome. The greatest threat that we are facing is the emergence of pan drug-resistant (PDR) organisms. Objectives To study bacterial organisms causing bloodstream infections (BSI) during febrile neutropenia episodes, their antibiotic sensitivity pattern, impact on treatment outcome during the intensive phase of chemotherapy, and the association between prior administration of antibiotics and emergence of multidrug-resistant organisms (MDR). Materials and Methods This retrospective study was conducted in patients between the age group of 0 to 18 years who were treated for malignancies in the division of pediatric oncology at a tertiary center from August 2017 to December 2020. Blood cultures were collected under aseptic precautions, and they were processed as per the Clinical and Laboratory Standard Institute Guideline (CLSI) 2017. Results A total of 122/159 (76.7%) patients were diagnosed to have hematological malignancies, and 37/159 (23.3%) patients were found to be suffering from solid tumors. A total of 309 episodes of FN were documented and 386 cultures were sent, out of which 87/386 (22.53%) cultures were positive for bacteria and 2/386 (2.2%) for fungi. Gram-negative isolates were seen in 51/87 (58.62%) cultures and Gram-positive in 36/87 (41.37%) cultures. Burkholderia cepacia and coagulase-negative Staphylococci (CONS) were the commonest found Gram-negative and Gram-positive bacteria, respectively. MDR bacterial strains were seen in 44/87 (50.57%) cultures and PDR strains in 8/87 (9.2%) cultures. Resistance was higher with Klebsiella species and CONS. There were six mortalities during the induction phase of acute leukemia treatment, out of which 4/6 (66.66%) were due to MDR infections, 1/6 (16.6%) due to fungal infection and chemotherapy refractoriness each. Conclusion Proven bacterial infections were determined in 22.53% of febrile neutropenia episodes. Most BSI in patients with febrile neutropenia were caused by Gram-negative bacteria. Indiscriminate use of higher antibiotics before referral led to the emergence of MDR organisms, thus compromising the outcome. Our study emphasizes the fact that antibiotic stewardship is a crucial task to counter MDR bacteremia-related morbidity and mortality in neutropenic children.

APA, Harvard, Vancouver, ISO, and other styles

50

Natarajan, Shiva, Shruthi Narayan, John A. Liu Yin, and Angela Chan. "The Use of Prophylactic Granulocyte-colony Stimulating Factor for Chemotherapy-induced Febrile Neutropenia." European Oncology & Haematology 08, no. 01 (2012): 14. http://dx.doi.org/10.17925/eoh.2012.08.01.14.

Full text

Abstract:

Febrile neutropenia (FN) is a common and serious complication of cytotoxic chemotherapy. It impairs the immune system, placing the cancer patient at risk of infection and is a key contributor to chemotherapy-associated morbidity and mortality. Factors including therapeutic regimen, tumour type and individual characteristics influence susceptibility to myelosuppression. Over the years, several granulocyte-colony stimulating factors (G-CSFs) have been developed for primary prophylaxis of FN including filgrastim, lenograstim and pegfilgrastim. These agents have demonstrated safety and efficacy in reducing FN in patients allowing for administration of optimal treatment and thereby improving clinical outcomes. They also support the use of dose-dense and dose-intense chemotherapy regimens found to be beneficial in some patients. Recently, the introduction of biosimilars of G-CSFs with proven comparability with the originator filgrastim has expanded the prophylactic therapies available. Effective use of these drugs by physicians early in the chemotherapy schedule may lead to fewer adverse events and improved survival.

APA, Harvard, Vancouver, ISO, and other styles

Journal articles on the topic 'Chemotherapy-induced febrile neutropenia'

Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles