治疗恶性瘤患者接受菲尔格拉斯蒂姆作为主要预防的患者的结果
Terra Furney1,2,3, Amy Horowitz1,2,3, John Malamakal1,2,3
1South Texas Veterans Health Care System, San Antonio.
概括
化学疗法诱导的中性质减退的每日菲尔格拉斯蒂姆预防是常见的. 虽然有效,但17%的患者经历了治疗延迟,这表明需要改善对绝对中性粒细胞计数的监测,以优化剂量和预防并发症.
科学领域:
- 在瘤学瘤学.
- 血液学 血液学 血液学
背景情况:
- 颗粒细胞殖民地刺激因子 (G-CSF) 预防可减少化疗诱导的中性质疏松症和发烧性中性质疏松症.
- 每日注射菲尔格拉斯蒂姆是南德克萨斯州退伍军人医疗保健系统中首选的G-CSF配方用于初级预防.
研究的目的:
- 为了评估每日使用菲尔格拉斯蒂姆的有效性,用于在高危癌症患者中发烧性中性质衰竭的初级预防.
- 评估治疗延迟,剂量修改,住院治疗和与每日使用菲尔格拉斯蒂姆相关的感染.
主要方法:
- 追溯性,单一中心的队列研究,包括59名每天接受费尔格拉斯蒂姆作为初级预防的患者.
- 纳入标准:治疗性癌症诊断,化学疗法方案中等至高风险的发烧性中性质衰竭.
- 主要结局:中性质衰竭/发烧性中性质衰竭的发生率导致治疗延迟.
主要成果:
- 17%的患者因中性质减弱/发烧性中性质减弱而出现治疗延迟.
- 25%的人住院治疗 (中位数为5天),15%的人患有感染,3%的人需要降低化疗剂量.
- 15%需要额外的菲尔格拉斯蒂姆剂量,15%转换为佩格菲尔格拉斯蒂姆.
结论:
- 每日使用菲尔格拉斯蒂姆导致显著比例的患者治疗延迟.
- 追踪nadir后绝对中性粒细胞计数对于优化filgrastim剂量和预防中性粒细胞衰竭相关并发症至关重要.
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