Cargando…

Appropriateness of granulocyte colony-stimulating factor use in patients receiving chemotherapy by febrile neutropenia risk level

OBJECTIVE: Inappropriate granulocyte colony-stimulating factor use with myelosuppressive chemotherapy has been reported. Using the Oncology Services Comprehensive Electronic Records electronic medical record database, prophylactic granulocyte colony-stimulating factor (pegfilgrastim/filgrastim) use...

Descripción completa

Detalles Bibliográficos
Autores principales: Baig, Hassam, Somlo, Barbara, Eisen, Melissa, Stryker, Scott, Bensink, Mark, Morrow, Phuong K
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6716357/
https://www.ncbi.nlm.nih.gov/pubmed/30200842
http://dx.doi.org/10.1177/1078155218799859
_version_ 1783447363525804032
author Baig, Hassam
Somlo, Barbara
Eisen, Melissa
Stryker, Scott
Bensink, Mark
Morrow, Phuong K
author_facet Baig, Hassam
Somlo, Barbara
Eisen, Melissa
Stryker, Scott
Bensink, Mark
Morrow, Phuong K
author_sort Baig, Hassam
collection PubMed
description OBJECTIVE: Inappropriate granulocyte colony-stimulating factor use with myelosuppressive chemotherapy has been reported. Using the Oncology Services Comprehensive Electronic Records electronic medical record database, prophylactic granulocyte colony-stimulating factor (pegfilgrastim/filgrastim) use in cancer patients was assessed by febrile neutropenia risk level. METHODS: Patients with nonmetastatic or metastatic breast, head/neck, colorectal, ovarian/gynecologic, lung cancer, or non-Hodgkin’s lymphoma who received myelosuppressive chemotherapy from June 2013 to May 2014 were included. Prophylactic granulocyte colony-stimulating factor use with high-risk, intermediate-risk, and low-risk chemotherapy and distribution of National Comprehensive Cancer Network risk factors with intermediate-risk regimens were assessed. RESULTS: Overall, 86,189 patients received ∼4.2 million chemotherapy cycles (high risk, 9%; intermediate risk, 48%; low risk, 43%). Prophylactic granulocyte colony-stimulating factor was given in 24% of cycles (high risk, 59%; intermediate risk, 29%; low risk, 11%). For nonmetastatic solid tumors, granulocyte colony-stimulating factor was given in 78% (high risk), 31% (intermediate risk), and 6% (low risk) of cycles. For metastatic solid tumors or non-Hodgkin’s lymphoma, granulocyte colony-stimulating factor was given in 50% (high risk), 27% (intermediate risk), and 11% (low risk) of cycles. Among patients receiving intermediate-risk regimens with granulocyte colony-stimulating factor, febrile neutropenia risk factors were identified in 56% (95% confidence interval, 51.1–60.9%) of patients with nonmetastatic solid tumors (n = 400) and in 70% (64.5–73.5%) of patients with metastatic solid tumors or non-Hodgkin’s lymphoma (n = 400). CONCLUSION: Prophylactic granulocyte colony-stimulating factor use was appropriately highest for high-risk regimens and lowest for low-risk regimens yet still potentially underused in high risk regimens, overused in low-risk regimens, and not appropriately targeted in intermediate-risk regimens, indicating a need for further education on febrile neutropenia risk evaluation and appropriate granulocyte colony-stimulating factor use.
format Online
Article
Text
id pubmed-6716357
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-67163572019-10-02 Appropriateness of granulocyte colony-stimulating factor use in patients receiving chemotherapy by febrile neutropenia risk level Baig, Hassam Somlo, Barbara Eisen, Melissa Stryker, Scott Bensink, Mark Morrow, Phuong K J Oncol Pharm Pract Original Articles OBJECTIVE: Inappropriate granulocyte colony-stimulating factor use with myelosuppressive chemotherapy has been reported. Using the Oncology Services Comprehensive Electronic Records electronic medical record database, prophylactic granulocyte colony-stimulating factor (pegfilgrastim/filgrastim) use in cancer patients was assessed by febrile neutropenia risk level. METHODS: Patients with nonmetastatic or metastatic breast, head/neck, colorectal, ovarian/gynecologic, lung cancer, or non-Hodgkin’s lymphoma who received myelosuppressive chemotherapy from June 2013 to May 2014 were included. Prophylactic granulocyte colony-stimulating factor use with high-risk, intermediate-risk, and low-risk chemotherapy and distribution of National Comprehensive Cancer Network risk factors with intermediate-risk regimens were assessed. RESULTS: Overall, 86,189 patients received ∼4.2 million chemotherapy cycles (high risk, 9%; intermediate risk, 48%; low risk, 43%). Prophylactic granulocyte colony-stimulating factor was given in 24% of cycles (high risk, 59%; intermediate risk, 29%; low risk, 11%). For nonmetastatic solid tumors, granulocyte colony-stimulating factor was given in 78% (high risk), 31% (intermediate risk), and 6% (low risk) of cycles. For metastatic solid tumors or non-Hodgkin’s lymphoma, granulocyte colony-stimulating factor was given in 50% (high risk), 27% (intermediate risk), and 11% (low risk) of cycles. Among patients receiving intermediate-risk regimens with granulocyte colony-stimulating factor, febrile neutropenia risk factors were identified in 56% (95% confidence interval, 51.1–60.9%) of patients with nonmetastatic solid tumors (n = 400) and in 70% (64.5–73.5%) of patients with metastatic solid tumors or non-Hodgkin’s lymphoma (n = 400). CONCLUSION: Prophylactic granulocyte colony-stimulating factor use was appropriately highest for high-risk regimens and lowest for low-risk regimens yet still potentially underused in high risk regimens, overused in low-risk regimens, and not appropriately targeted in intermediate-risk regimens, indicating a need for further education on febrile neutropenia risk evaluation and appropriate granulocyte colony-stimulating factor use. SAGE Publications 2018-09-10 2019-10 /pmc/articles/PMC6716357/ /pubmed/30200842 http://dx.doi.org/10.1177/1078155218799859 Text en © The Author(s) 2018 http://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Articles
Baig, Hassam
Somlo, Barbara
Eisen, Melissa
Stryker, Scott
Bensink, Mark
Morrow, Phuong K
Appropriateness of granulocyte colony-stimulating factor use in patients receiving chemotherapy by febrile neutropenia risk level
title Appropriateness of granulocyte colony-stimulating factor use in patients receiving chemotherapy by febrile neutropenia risk level
title_full Appropriateness of granulocyte colony-stimulating factor use in patients receiving chemotherapy by febrile neutropenia risk level
title_fullStr Appropriateness of granulocyte colony-stimulating factor use in patients receiving chemotherapy by febrile neutropenia risk level
title_full_unstemmed Appropriateness of granulocyte colony-stimulating factor use in patients receiving chemotherapy by febrile neutropenia risk level
title_short Appropriateness of granulocyte colony-stimulating factor use in patients receiving chemotherapy by febrile neutropenia risk level
title_sort appropriateness of granulocyte colony-stimulating factor use in patients receiving chemotherapy by febrile neutropenia risk level
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6716357/
https://www.ncbi.nlm.nih.gov/pubmed/30200842
http://dx.doi.org/10.1177/1078155218799859
work_keys_str_mv AT baighassam appropriatenessofgranulocytecolonystimulatingfactoruseinpatientsreceivingchemotherapybyfebrileneutropeniarisklevel
AT somlobarbara appropriatenessofgranulocytecolonystimulatingfactoruseinpatientsreceivingchemotherapybyfebrileneutropeniarisklevel
AT eisenmelissa appropriatenessofgranulocytecolonystimulatingfactoruseinpatientsreceivingchemotherapybyfebrileneutropeniarisklevel
AT strykerscott appropriatenessofgranulocytecolonystimulatingfactoruseinpatientsreceivingchemotherapybyfebrileneutropeniarisklevel
AT bensinkmark appropriatenessofgranulocytecolonystimulatingfactoruseinpatientsreceivingchemotherapybyfebrileneutropeniarisklevel
AT morrowphuongk appropriatenessofgranulocytecolonystimulatingfactoruseinpatientsreceivingchemotherapybyfebrileneutropeniarisklevel