Ghent University Academic Bibliography

Advanced

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

Laetitia Gerlier, Mark Lamotte, Ahmad Awada, André Bosly, Greet Bries, Veronique Cocquyt UGent, Christian Focan, Stephanie Henry, Yassine Lalami, Jean-Pascal Machiels, et al. (2010) BMC CANCER. 10.
abstract
Background: The 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. Methods: Nine 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. Results: The 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. Conclusions: Despite 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.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
CHOP, COLONY-STIMULATING FACTOR, RECOMMENDATIONS, MORTALITY, GROWTH-FACTORS, DOSE INTENSITY, CLINICAL-PRACTICE, QUALITY-OF-LIFE, PATIENTS RECEIVING CHEMOTHERAPY, OBSERVATIONAL EUROPEAN NEUTROPENIA
journal title
BMC CANCER
BMC Cancer
volume
10
article number
642
pages
10 pages
Web of Science type
Article
Web of Science id
000285553500001
JCR category
ONCOLOGY
JCR impact factor
3.153 (2010)
JCR rank
66/181 (2010)
JCR quartile
2 (2010)
ISSN
1471-2407
DOI
10.1186/1471-2407-10-642
language
English
UGent publication?
yes
classification
A1
copyright statement
I have retained and own the full copyright for this publication
id
1195807
handle
http://hdl.handle.net/1854/LU-1195807
date created
2011-03-23 17:49:56
date last changed
2016-12-21 15:41:40
@article{1195807,
  abstract     = {Background: The 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.
Methods: Nine 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 {\textlangle}65 years with breast cancer or NHL. Data were retrospectively obtained, over a 6-month observation period.
Results: The 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.
Conclusions: Despite 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.},
  articleno    = {642},
  author       = {Gerlier, Laetitia and Lamotte, Mark and Awada, Ahmad and Bosly, Andr{\'e} and Bries, Greet and Cocquyt, Veronique and Focan, Christian and Henry, Stephanie and Lalami, Yassine and Machiels, Jean-Pascal and Mebis, Jeroen and Straetmans, Nicole and Verhoeven, Didier and Somers, Luc},
  issn         = {1471-2407},
  journal      = {BMC CANCER},
  keyword      = {CHOP,COLONY-STIMULATING FACTOR,RECOMMENDATIONS,MORTALITY,GROWTH-FACTORS,DOSE INTENSITY,CLINICAL-PRACTICE,QUALITY-OF-LIFE,PATIENTS RECEIVING CHEMOTHERAPY,OBSERVATIONAL EUROPEAN NEUTROPENIA},
  language     = {eng},
  pages        = {10},
  title        = {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},
  url          = {http://dx.doi.org/10.1186/1471-2407-10-642},
  volume       = {10},
  year         = {2010},
}

Chicago
Gerlier, Laetitia, Mark Lamotte, Ahmad Awada, André Bosly, Greet Bries, Veronique Cocquyt, Christian Focan, et al. 2010. “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 10.
APA
Gerlier, L., Lamotte, M., Awada, A., Bosly, A., Bries, G., Cocquyt, V., Focan, C., et al. (2010). 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, 10.
Vancouver
1.
Gerlier L, Lamotte M, Awada A, Bosly A, Bries G, Cocquyt V, et al. 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. 2010;10.
MLA
Gerlier, Laetitia, Mark Lamotte, Ahmad Awada, et al. “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 10 (2010): n. pag. Print.