Continuous Intravenous Administration of Granulocyte-Colony-Stimulating Factors—A Breakthrough in the Treatment of Cancer Patients with Febrile Neutropenia
| Autor: | Calin Cainap, Ovidiu Balacescu, Alina Simona Bereanu, Cristina Crisan, Andra Mester, Anne-Marie Constantin, Laura Pop, Irina Dicu, Crişan Ovidiu, Sânziana Cetean-Gheorghe, Patriciu Achimas-Cadariu, Daniel Corneliu Leucuta, Adina Stan, Doina Piciu, Alexandra Gherman, Catalin Vlad, Simona Cainap, Loredana Balacescu |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Medicine (General) Side effect medicine.medical_treatment Neutropenia G-CSF febrile chemotherapy Gastroenterology Article Procalcitonin R5-920 Neoplasms Internal medicine Antineoplastic Combined Chemotherapy Protocols Granulocyte Colony-Stimulating Factor medicine Humans neutropenia cancer Prospective Studies Prospective cohort study Febrile Neutropenia Chemotherapy biology business.industry Standard treatment C-reactive protein General Medicine medicine.disease biology.protein Administration Intravenous Female business Febrile neutropenia Granulocytes |
| Zdroj: | Medicina, Vol 57, Iss 675, p 675 (2021) Medicina Volume 57 Issue 7 |
| ISSN: | 1648-9144 |
| Popis: | (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/mm3 and leucocytes (WBC) 1875/mm3 at the time of FN. Ten patients possess PMN less than 100/mm3. 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: | OpenAIRE |
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