Cancer Chemotherapy, Neutropenia and the Use of Myeloid Growth Factors

Only available on StudyMode
  • Topic: Chemotherapy, Lymphoma, Cancer
  • Pages : 2 (274 words )
  • Download(s) : 30
  • Published : April 28, 2013
Open Document
Text Preview
Slide 1

Cancer Chemotherapy, Neutropenia and the use of Myeloid Growth Factors

Dr. David E. Chase Pharm D

Intro about self and presentation

Slide 2

Case Presentation- Ms. K
69 year old retired female executive who presents with chest pain and mild fatigue. Exam  Bilateral cervical, axillary and inguinal adenopathy  PS-1 Labs Hgb 10.5g/dl  WBC 4200/mm³  ANC 2100/mm³  Platelet Count 120,000  Creatinine 1.2 

Slide 3

Case Presentation – Ms. K
CT Scan • Hilar and mediastinal adenopathy Cervical lymph node biopsy • Diffuse anaplastic lymphoma, stage III Treatment • R-CHOP chemotherapy every 3 weeks for 6 cycles (based on response)

Slide 4

R-CHOP Ms. K. Therapy Options
Prior to starting R-CHOP, you discuss complications of chemotherapy-neutropenia  

Dose reduction of R-CHOP Standard dose of R-CHOP plus prophylactic antibiotics




Standard dose of R-CHOP plus prophylactic CSF support
Standard dose of R-CHOP plus prophylactic CSF support and antibiotics Standard dose of R-CHOP alone and treat with antibiotics and CSF as needed if neutropenic complications develop



What if we change diagnosis to small cell?

Slide 5

Chemotherapy-induced neutropenia & its complications
Myelosuppressive chemotherapy
Neutropenia
Febrile neutropenia (FN) Chemotherapy dose delays and dose reductions

Complicated life-threatening infection and prolonged hospitalization Reduced survival

Decreased relative dose intensity (RDI)

Kuderer NM et al. Cancer 2006;106:2258-2266 Chirivella I et al. J Clin Oncol 2006;24:abstract 668 Bosly A et al. Ann Hematol 2008;87:277-283

So the problem with myelosuppressive chemotherapy

Slide 6

Risk of FN increases with duration of severe neutropenia*
120
Predicted probability of FN (%) (temperature >38.2 C and ANC 9
tracking img