Canadian supportive care recommendations for the management of neutropema in patients with cancer

C. Tom Kouroukis, Stephen Chia, Sunil Verma, Danny Robson, Christine Desbiens, Christine Cripps, Joseph Mikhael

Research output: Contribution to journalReview article

23 Scopus citations

Abstract

Hematologic toxicities of cancer chemotherapy are common and often limit the ability to provide treatment in a timely and dose-intensive manner. These limitations may be of utmost importance in the adjuvant and curative intent settings. Hematologic toxicities may result in febrile neutropenia, infections, fatigue, and bleeding, all of which may lead to additional complications and prolonged hospitalization. The older cancer patient and patients with significant comorbidities may be at highest risk of neutropenic complications. Colony-stimulating factors (CSFS) such as filgrastim and pegfilgrastim can effectively attenuate most of the neutropenic consequences of chemotherapy, improve the ability to continue chemotherapy on the planned schedule, and minimize the risk of febrile neutropenia and infectious morbidity and mortality. The present consensus statement reviews the use of CSFS in the management of neutropenia in patients with cancer and sets out specific recommendations based on published international guidelines tailored to the specifics of the Canadian practice landscape. We review existing international guidelines, the indications for primary and secondary prophylaxis, the importance of maintaining dose intensity, and the use of CSFS in leukemia, stem-cell transplantation, and radiotherapy. Specific disease-related recommendations are provided related to breast cancer, non-Hodgkin lymphoma, lung cancer, and gastrointestinal cancer. Finally, CSF dosing and schedules, duration of therapy, and associated acute and potential chronic toxicities are examined.

Original languageEnglish (US)
Pages (from-to)9-23
Number of pages15
JournalCurrent Oncology
Volume15
Issue number1
DOIs
StatePublished - 2008

Keywords

  • Canadian recommendations
  • Chemotherapy-induced neutropenia
  • Colony-stimulating factors
  • Febrile neutropenia
  • Neutropenia
  • Safety
  • Supportive care

ASJC Scopus subject areas

  • Oncology

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  • Cite this

    Kouroukis, C. T., Chia, S., Verma, S., Robson, D., Desbiens, C., Cripps, C., & Mikhael, J. (2008). Canadian supportive care recommendations for the management of neutropema in patients with cancer. Current Oncology, 15(1), 9-23. https://doi.org/10.3747/co.2008.198