Risk of chemotherapy-induced febrile neutropenia in patients with metastatic cancer not receiving granulocyte colony-sti
- PDF / 797,154 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 69 Downloads / 191 Views
ORIGINAL ARTICLE
Risk of chemotherapy-induced febrile neutropenia in patients with metastatic cancer not receiving granulocyte colony-stimulating factor prophylaxis in US clinical practice Ahuva Averin 1 & Amanda Silvia 1 & Lois Lamerato 2 & Kathryn Richert-Boe 3 & Manpreet Kaur 2 & Devi Sundaresan 4 & Neel Shah 5 & Mark Hatfield 5 & Tatiana Lawrence 5 & Gary H. Lyman 6 & Derek Weycker 1 Received: 2 July 2020 / Accepted: 21 August 2020 # The Author(s) 2020
Abstract Objectives To evaluate the use of granulocyte colony-stimulating factor (G-CSF) prophylaxis in US patients with selected metastatic cancers and chemotherapy-induced febrile neutropenia (FN) incidence and associated outcomes among the subgroup who did not receive prophylaxis. Methods This retrospective cohort study was conducted at four US health systems and included adults with metastatic cancer (breast, colorectal, lung, non-Hodgkin lymphoma [NHL]) who received myelosuppressive chemotherapy (2009– 2017). Patients were stratified by FN risk level based on risk factors and chemotherapy (low/unclassified risk, intermediate risk without any risk factors, intermediate risk with ≥ 1 risk factor [IR + 1], high risk [HR]). G-CSF use was evaluated among all patients stratified by FN risk, and FN/FN-related outcomes were evaluated among patients who did not receive first-cycle G-CSF prophylaxis. Results Among 1457 metastatic cancer patients, 20.5% and 28.1% were classified as HR and IR + 1, respectively. Firstcycle G-CSF prophylaxis use was 48.5% among HR patients and 13.9% among IR + 1 patients. In the subgroup not receiving first-cycle G-CSF prophylaxis, FN incidence in cycle 1 was 7.8% for HR patients and 4.8% for IR + 1 patients; during the course, corresponding values were 16.9% and 15.9%. Most (> 90%) FN episodes required hospitalization, and mortality risk ranged from 7.1 to 26.9% across subgroups. Conclusion In this retrospective study, the majority of metastatic cancer chemotherapy patients for whom G-CSF prophylaxis is recommended did not receive it; FN incidence in this subgroup was notably high. Patients with elevated FN risk should be carefully identified and managed to ensure appropriate use of supportive care. Keywords Granulocyte colony-stimulating factor . Febrile neutropenia . Breast cancer . Colorectal cancer . Lung cancer . Non-Hodgkin lymphoma
Introduction Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00520-020-05715-3) contains supplementary material, which is available to authorized users. * Derek Weycker [email protected] 1
Policy Analysis Inc. (PAI), Four Davis Court, Brookline, MA 02445, USA
2
Henry Ford Health System, Detroit, MI, USA
3
Kaiser Permanente Northwest, Portland, OR, USA
4
Reliant Medical Group, Worcester, MA, USA
5
Amgen Inc., Thousand Oaks, CA, USA
6
Fred Hutchinson Cancer Research Center, Seattle, WA, USA
A common challenge in the treatment of nonmyeloid neoplastic disease is the development of chemotherapyinduced neutropenia [1–5], a condition in which the a
Data Loading...
