Neutropenia: Difference between revisions
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==Prevention== | ==Prevention== | ||
Hematopoietic colony-stimulating factors for [[primary prevention]] of febrile neutropenia may not decrease mortality but do decrease infections in patients undergoing cancer chemotherapy or stem cell transplantation according to a [[systematic review]].<ref name="pmid17876022">{{cite journal |author=Sung L, Nathan PC, Alibhai SM, Tomlinson GA, Beyene J |title=Meta-analysis: effect of prophylactic hematopoietic colony-stimulating factors on mortality and outcomes of infection |journal=Ann. Intern. Med. |volume=147 |issue=6 |pages=400–11 |year=2007 |month=September |pmid=17876022 |doi= |url=http://www.annals.org/cgi/pmidlookup?view=reprint&pmid=17876022 |issn=}}</ref> | |||
Granulocyte colony-stimulating factor is indicated in selected settings<ref name="pmid17634496">{{cite journal |author=Kuderer NM, Dale DC, Crawford J, Lyman GH |title=Impact of primary prophylaxis with granulocyte colony-stimulating factor on febrile neutropenia and mortality in adult cancer patients receiving chemotherapy: a systematic review |journal=J. Clin. Oncol. |volume=25 |issue=21 |pages=3158–67 |year=2007 |pmid=17634496 |doi=10.1200/JCO.2006.08.8823}} [http://www.acpjc.org/Content/148/1/issue/ACPJC-2008-148-1-007.htm ACP JC Review]</ref><ref name="isbn1-55009-213-8">{{cite book |author=Frei, Emil; Kufe, Donald W.; Holland, James F. |title=Cancer medicine 6: Granulocyte colony-stimulating factor | Granulocyte colony-stimulating factor is indicated in selected settings<ref name="pmid17634496">{{cite journal |author=Kuderer NM, Dale DC, Crawford J, Lyman GH |title=Impact of primary prophylaxis with granulocyte colony-stimulating factor on febrile neutropenia and mortality in adult cancer patients receiving chemotherapy: a systematic review |journal=J. Clin. Oncol. |volume=25 |issue=21 |pages=3158–67 |year=2007 |pmid=17634496 |doi=10.1200/JCO.2006.08.8823}} [http://www.acpjc.org/Content/148/1/issue/ACPJC-2008-148-1-007.htm ACP JC Review]</ref><ref name="isbn1-55009-213-8">{{cite book |author=Frei, Emil; Kufe, Donald W.; Holland, James F. |title=Cancer medicine 6: Granulocyte colony-stimulating factor | ||
|publisher=BC Decker |location=Hamilton, Ont |year=2003 |pages= |isbn=1-55009-213-8 |oclc= |doi=}}[http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=cmed6.section.14491#14497 Full text]</ref> if the projected chance of febrile neutropenia is at least 20%.<ref name="pmid16682719">{{cite journal |author=Smith TJ, Khatcheressian J, Lyman GH, ''et al'' |title=2006 update of recommendations for the use of white blood cell growth factors: an evidence-based clinical practice guideline |journal=J. Clin. Oncol. |volume=24 |issue=19 |pages=3187–205 |year=2006 |pmid=16682719 |doi=10.1200/JCO.2006.06.4451}}</ref> | |publisher=BC Decker |location=Hamilton, Ont |year=2003 |pages= |isbn=1-55009-213-8 |oclc= |doi=}}[http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=cmed6.section.14491#14497 Full text]</ref> if the projected chance of febrile neutropenia is at least 20%.<ref name="pmid16682719">{{cite journal |author=Smith TJ, Khatcheressian J, Lyman GH, ''et al'' |title=2006 update of recommendations for the use of white blood cell growth factors: an evidence-based clinical practice guideline |journal=J. Clin. Oncol. |volume=24 |issue=19 |pages=3187–205 |year=2006 |pmid=16682719 |doi=10.1200/JCO.2006.06.4451}}</ref> | ||
Revision as of 14:52, 20 June 2008
The half-life of a neutrophil is less than one-half of a day. [1]
Diagnosis
Grading
Grading is:[2]
- Grade 1: < 2.0 x 109/L (< 2000/mm3) and > 1.1 x 109/L (> 1500/mm3)
- Grade 2: < 1.5 x 109/L (< 1500/mm3) and > 1.0 x 109/L (> 1000/mm3)
- Grade 3: < 1.0 x 109/L (< 1000/mm3) and > 0.5 x 109/L (> 500/mm3)
- Grade 4: < 0.5 x 109/L (< 500/mm3)
Febrile neutropenia
Clinical practice guidelines define febrile neutropenia as "a single oral temperature of >=38.3°C (101°F) or a temperature of >=38.0°C (100.4°F) for >= 1 h. Neutropenia is defined as a neutrophil count of <500 cells/mm3, or a count of <1000 cells/mm3 with a predicted decrease to <500 cells/mm3"[3]
A clinical prediction rule can estimate the risk of morbidity in the febrile patient with neutropenia.[4] A score of >=21 indicates low risk.
Prevention
Hematopoietic colony-stimulating factors for primary prevention of febrile neutropenia may not decrease mortality but do decrease infections in patients undergoing cancer chemotherapy or stem cell transplantation according to a systematic review.[5]
Granulocyte colony-stimulating factor is indicated in selected settings[6][7] if the projected chance of febrile neutropenia is at least 20%.[8]
References
- ↑ Carneiro, José; Junqueira, Luiz Carlos Uchôa (2005). Basic histology: text & atlas. New York: McGraw-Hill, Medical Pub. Division. ISBN 0-07-144091-7.
- ↑ Anonymous (1999). Common Toxicity Criteria (CTC). Cancer Therapy Evaluation Program. Retrieved on 2008-01-06.
- ↑ Hughes WT, Armstrong D, Bodey GP, et al (2002). "2002 guidelines for the use of antimicrobial agents in neutropenic patients with cancer". Clin. Infect. Dis. 34 (6): 730–51. DOI:10.1086/339215. PMID 11850858. Research Blogging.
- ↑ Klastersky J, Paesmans M, Rubenstein EB, et al (2000). "The Multinational Association for Supportive Care in Cancer risk index: A multinational scoring system for identifying low-risk febrile neutropenic cancer patients". J. Clin. Oncol. 18 (16): 3038–51. PMID 10944139. [e] (See Table 4 for the prediction rule)
- ↑ Sung L, Nathan PC, Alibhai SM, Tomlinson GA, Beyene J (September 2007). "Meta-analysis: effect of prophylactic hematopoietic colony-stimulating factors on mortality and outcomes of infection". Ann. Intern. Med. 147 (6): 400–11. PMID 17876022. [e]
- ↑ Kuderer NM, Dale DC, Crawford J, Lyman GH (2007). "Impact of primary prophylaxis with granulocyte colony-stimulating factor on febrile neutropenia and mortality in adult cancer patients receiving chemotherapy: a systematic review". J. Clin. Oncol. 25 (21): 3158–67. DOI:10.1200/JCO.2006.08.8823. PMID 17634496. Research Blogging. ACP JC Review
- ↑ Frei, Emil; Kufe, Donald W.; Holland, James F. (2003). Cancer medicine 6: Granulocyte colony-stimulating factor. Hamilton, Ont: BC Decker. ISBN 1-55009-213-8. Full text
- ↑ Smith TJ, Khatcheressian J, Lyman GH, et al (2006). "2006 update of recommendations for the use of white blood cell growth factors: an evidence-based clinical practice guideline". J. Clin. Oncol. 24 (19): 3187–205. DOI:10.1200/JCO.2006.06.4451. PMID 16682719. Research Blogging.