Appropriateness of granulocyte colony-stimulating factor use in patients receiving chemotherapy by febrile neutropenia risk level
| Autor: | Mark Bensink, Melissa Eisen, Scott Stryker, Phuong Khanh Morrow, Barbara Somlo, Hassam A. Baig |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Oncology medicine.medical_specialty Adolescent Filgrastim medicine.medical_treatment Antineoplastic Agents Granulocyte chemotherapy Polyethylene Glycols Young Adult Granulocyte colony-stimulating factor 03 medical and health sciences metastatic cancer 0302 clinical medicine Risk Factors Neoplasms Internal medicine medicine Humans Pharmacology (medical) In patient Aged appropriate use Risk level Chemotherapy Myelosuppressive Chemotherapy business.industry risk assessment Original Articles Middle Aged medicine.disease febrile neutropenia medicine.anatomical_structure 030220 oncology & carcinogenesis Female business Risk assessment Febrile neutropenia 030215 immunology |
| Zdroj: | Journal of Oncology Pharmacy Practice |
| ISSN: | 1477-092X 1078-1552 |
| DOI: | 10.1177/1078155218799859 |
| Popis: | ObjectiveInappropriate granulocyte colony-stimulating factor use with myelosuppressive chemotherapy has been reported. Using the Oncology Services Comprehensive Electronic Records electronic medical record database, prophylactic granulocyte colony-stimulating factor (pegfilgrastim/filgrastim) use in cancer patients was assessed by febrile neutropenia risk level.MethodsPatients with nonmetastatic or metastatic breast, head/neck, colorectal, ovarian/gynecologic, lung cancer, or non-Hodgkin’s lymphoma who received myelosuppressive chemotherapy from June 2013 to May 2014 were included. Prophylactic granulocyte colony-stimulating factor use with high-risk, intermediate-risk, and low-risk chemotherapy and distribution of National Comprehensive Cancer Network risk factors with intermediate-risk regimens were assessed.ResultsOverall, 86,189 patients received ∼4.2 million chemotherapy cycles (high risk, 9%; intermediate risk, 48%; low risk, 43%). Prophylactic granulocyte colony-stimulating factor was given in 24% of cycles (high risk, 59%; intermediate risk, 29%; low risk, 11%). For nonmetastatic solid tumors, granulocyte colony-stimulating factor was given in 78% (high risk), 31% (intermediate risk), and 6% (low risk) of cycles. For metastatic solid tumors or non-Hodgkin’s lymphoma, granulocyte colony-stimulating factor was given in 50% (high risk), 27% (intermediate risk), and 11% (low risk) of cycles. Among patients receiving intermediate-risk regimens with granulocyte colony-stimulating factor, febrile neutropenia risk factors were identified in 56% (95% confidence interval, 51.1–60.9%) of patients with nonmetastatic solid tumors (n = 400) and in 70% (64.5–73.5%) of patients with metastatic solid tumors or non-Hodgkin’s lymphoma (n = 400).ConclusionProphylactic granulocyte colony-stimulating factor use was appropriately highest for high-risk regimens and lowest for low-risk regimens yet still potentially underused in high risk regimens, overused in low-risk regimens, and not appropriately targeted in intermediate-risk regimens, indicating a need for further education on febrile neutropenia risk evaluation and appropriate granulocyte colony-stimulating factor use. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|