Continuous Intravenous Administration of Granulocyte-Colony-Stimulating Factors-A Breakthrough in the Treatment of Cancer Patients with Febrile Neutropenia.

Autor:	Căinap C; Faculty of Medicine, 'Iuliu Hațieganu' University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania.; Ion Chiricuta Institute of Oncology, 400015 Cluj-Napoca, Romania., Cetean-Gheorghe S; Faculty of Pharmacy, 'Iuliu Hațieganu' University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania., Pop LA; Research Center for Functional Genomics, Biomedicine and Translational Medicine, University of Medicine and Pharmacy Iuliu Hatieganu, 400000 Cluj-Napoca, Romania., Leucuta DC; Faculty of Medicine, 'Iuliu Hațieganu' University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania., Piciu D; Faculty of Medicine, 'Iuliu Hațieganu' University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania.; Ion Chiricuta Institute of Oncology, 400015 Cluj-Napoca, Romania., Mester A; Faculty of Medicine, 'Iuliu Hațieganu' University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania.; Ion Chiricuta Institute of Oncology, 400015 Cluj-Napoca, Romania., Vlad C; Faculty of Medicine, 'Iuliu Hațieganu' University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania.; Ion Chiricuta Institute of Oncology, 400015 Cluj-Napoca, Romania., Ovidiu C; Faculty of Pharmacy, 'Iuliu Hațieganu' University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania., Gherman A; Faculty of Medicine, 'Iuliu Hațieganu' University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania.; Ion Chiricuta Institute of Oncology, 400015 Cluj-Napoca, Romania., Crişan C; Ion Chiricuta Institute of Oncology, 400015 Cluj-Napoca, Romania., Bereanu A; Faculty of Medicine, 'Lucian Blaga' University of Sibiu, 550024 Sibiu, Romania., Bălăcescu O; Ion Chiricuta Institute of Oncology, 400015 Cluj-Napoca, Romania., Constantin AM; Faculty of Medicine, 'Iuliu Hațieganu' University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania., Dicu I; Ion Chiricuta Institute of Oncology, 400015 Cluj-Napoca, Romania., Bălăcescu L; Ion Chiricuta Institute of Oncology, 400015 Cluj-Napoca, Romania., Stan A; Faculty of Medicine, 'Iuliu Hațieganu' University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania., Achimaş-Cadariu P; Faculty of Medicine, 'Iuliu Hațieganu' University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania.; Ion Chiricuta Institute of Oncology, 400015 Cluj-Napoca, Romania., Căinap S; Faculty of Medicine, 'Iuliu Hațieganu' University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania.
Jazyk:	angličtina
Zdroj:	Medicina (Kaunas, Lithuania) [Medicina (Kaunas)] 2021 Jun 30; Vol. 57 (7). Date of Electronic Publication: 2021 Jun 30.
DOI:	10.3390/medicina57070675
Abstrakt:	(1) Background: Febrile neutropenia (FN) remains one of the most challenging problems in medical oncology and is a very severe side effect of chemotherapy. Its late consequences, when it is recurrent or of a severe grade, are dose reduction and therapy delays. Current guidelines allow the administration of granulocyte-colony-stimulating factors (G-CSF) for profound FN (except for the case when a pegylated form of G-CSF is administrated with prophylactic intention) in addition to antibiotics and supportive care. (2) Methods: This is a prospective study that included 96 patients with confirmed malignancy, treated with chemotherapy, who developed FN during their oncological therapy, and were hospitalized. They received standard treatment plus a dose of G-CSF of 16 µg/Kg/day IV continuous infusion. (3) Results: The gender distribution was almost symmetrical: Male patients made up 48.96% and 51.04% were female patients, with no significance on recovery from FN ( p = 1.00). The patients who received prophylactic G-CSF made up 20.21%, but this was not a predictive or prognostic factor for the recovery time from aplasia ( p = 0.34). The median chemotherapy line where patients with FN were included was two and the number of previous chemotherapy cycles before FN was three. The median serological number of neutrophils (PMN) was 450/mm 3 and leucocytes (WBC) 1875/mm 3 at the time of FN. Ten patients possess PMN less than 100/mm 3 . The median time to recovery was 25.5 h for 96 included patients, with one failure in which the patient possessed grade 5 FN. Predictive factors for shorter recovery time were lower levels of C reactive protein ( p < 0.001) and procalcitonin ( p = 0.002) upon hospital admission and higher WBC ( p = 0.006) and PMN ( p < 0.001) at the time of the provoking cycle of chemotherapy for FN. The best chance for a shorter duration of FN was a short history of chemotherapy regarding the number of cycles) ( p < 0.0001). (4) Conclusions: Continuous IV administration of G-CSF could be an alternative salvage treatment for patients with profound febrile neutropenia, with a very fast recovery time for neutrophiles.
Databáze:	MEDLINE
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