The use of chemotherapy regimens carrying a moderate or high risk of febrile neutropenia and the corresponding management of febrile neutropenia: an expert survey in breast cancer and non-Hodgkin's lymphoma

BMC Cancer

Research Article

Nicole Straetmans¹  André Bosly²  Greet Bries³  Christian Focan⁴  Stéphanie Henry⁵  Laetitia Gerlier⁶  Mark Lamotte⁶  Yassine Lalami⁷  Ahmad Awada⁷  Didier Verhoeven⁸  Jean-Pascal Machiels⁹  Véronique Cocquyt^1,10  Jeroen Mebis^1,11  Luc Somers^1,12 

[1] Department of Hematology, Jolimont Hospital, rue Ferrer, 159, B-7100, Haine-Saint-Paul, Belgium;Department of Hematology, University Hospital of Mont-Godinne, Avenue Dr G. Therasse, 1, B-5530, Yvoir, Belgium;Department of Hematology, Virga Jesse Hospital, Stadsomvaart, 11, B-3500, Hasselt, Belgium;Department of Oncology, CHC-Saint-Joseph Clinic, B-4000, rue de Hesbaye, 75, Liège, Belgium;Department of Oncology, University Hospital of Mont-Godinne, Avenue Dr G. Therasse, 1, B-5530, Yvoir, Belgium;Medical Oncology, Sainte-Elisabeth Clinic, place Louise Godin, 15, B-5000, Namur, Belgium;Health Economics and Outcomes Research Department, IMS Health Consulting, Medialaan 38, 1800, Vilvoorde, Belgium;Medical Oncology Clinic, Jules Bordet Institute, boulevard de Waterloo, 121, B-1000, Brussels, Belgium;Medical Oncology, Iridiumkankernetwerk, AZ Klina, Augustijnslei 100, B-2930, Brasschaat, Belgium;Medical Oncology, UCL Saint-Luc University Hospital, B-1200, Avenue Hippocrate 10, Brussels, Belgium;Medical Oncology, University Hospital Ghent, B-9000, De Pintelaan, 185, Gent, Belgium;Medical Oncology, Virga Jesse Hospital, Stadsomvaart, 11, B-3500, Hasselt, Belgium;OncoLogX, Arthur Boelstraat 66, B-2990, Wuustwezel, Belgium;

关键词: Breast Cancer;    Breast Cancer Patient;    Chemotherapy Cycle;    Pegfilgrastim;    Primary Prophylaxis;   

DOI  :  10.1186/1471-2407-10-642

 received in 2010-04-27, accepted in 2010-11-23,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundThe use of chemotherapy regimens with moderate or high risk of febrile neutropenia (defined as having a FN incidence of 10% or more) and the respective incidence and clinical management of FN in breast cancer and NHL has not been studied in Belgium. The existence of a medical need for G-CSF primary and secondary prophylaxis with these regimens was investigated in a real-life setting.MethodsNine oncologists and six hematologists from different Belgian general hospitals and university centers were surveyed to collect expert opinion and real-life data (year 2007) on the use of chemotherapy regimens with moderate or high risk of febrile neutropenia and the clinical management of FN in patients aged <65 years with breast cancer or NHL. Data were retrospectively obtained, over a 6-month observation period.ResultsThe most frequently used regimens in breast cancer patients (n = 161) were FEC (45%), FEC-T (37%) and docetaxel alone (6%). In NHL patients (n = 39), R-CHOP-21 (33%) and R-ACVBP-14 (15%) were mainly used. Without G-CSF primary prophylaxis (PP), FN occurred in 31% of breast cancer patients, and 13% had PSN. After G-CSF secondary prophylaxis (SP), 4% experienced further FN events. Only 1 breast cancer patient received PP, and did not experience a severe neutropenic event. Overall, 30% of chemotherapy cycles observed in breast cancer patients were protected by PP/SP. In 10 NHL patients receiving PP, 2 (20%) developed FN, whereas 13 (45%) of the 29 patients without PP developed FN and 3 (10%) PSN. Overall, 55% of chemotherapy cycles observed in NHL patients were protected by PP/SP. Impaired chemotherapy delivery (timing and/or dose) was reported in 40% (breast cancer) and 38% (NHL) of patients developing FN. Based on oncologist expert opinion, hospitalization rates for FN (average length of stay) without and with PP were, respectively, 48% (4.2 days) and 19% (1.5 days). Similar rates were obtained from hematologists.ConclusionsDespite the studied chemotherapy regimens being known to be associated with a moderate or high risk of FN, upfront G-CSF prophylaxis was rarely used. The observed incidence of severe neutropenic events without G-CSF prophylaxis was higher than generally reported in the literature. The impact on medical resources used is sizeable.

【 授权许可】

CC BY   
© Gerlier et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.