Impact of recommended weight-based dosing of granulocyte-colony stimulating factors in acute leukemia and stem cell transplant patients.
Identifieur interne : 001341 ( Main/Exploration ); précédent : 001340; suivant : 001342Impact of recommended weight-based dosing of granulocyte-colony stimulating factors in acute leukemia and stem cell transplant patients.
Auteurs : Jennifer K Hockings [États-Unis] ; Diwura K Owolabi [États-Unis] ; Joyce E. Broyles [États-Unis] ; Susan C Wheelis [États-Unis]Source :
- Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer [ 1433-7339 ] ; 2017.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen (MeSH), Facteur de stimulation des colonies de granulocytes (usage thérapeutique), Femelle (MeSH), Fièvre (prévention et contrôle), Humains (MeSH), Leucémie aigüe myéloïde (traitement médicamenteux), Mâle (MeSH), Neutropénie (prévention et contrôle), Poids (MeSH), Transplantation de cellules souches (méthodes), Études rétrospectives (MeSH).
- MESH :
- méthodes : Transplantation de cellules souches.
- prévention et contrôle : Fièvre, Neutropénie.
- traitement médicamenteux : Leucémie aigüe myéloïde.
- usage thérapeutique : Facteur de stimulation des colonies de granulocytes.
- Adulte d'âge moyen, Femelle, Humains, Mâle, Poids, Études rétrospectives.
English descriptors
- KwdEn :
- Body Weight (MeSH), Female (MeSH), Fever (prevention & control), Granulocyte Colony-Stimulating Factor (therapeutic use), Humans (MeSH), Leukemia, Myeloid, Acute (drug therapy), Male (MeSH), Middle Aged (MeSH), Neutropenia (prevention & control), Retrospective Studies (MeSH), Stem Cell Transplantation (methods).
- MESH :
- chemical , therapeutic use : Granulocyte Colony-Stimulating Factor.
- drug therapy : Leukemia, Myeloid, Acute.
- methods : Stem Cell Transplantation.
- prevention & control : Fever, Neutropenia.
- Body Weight, Female, Humans, Male, Middle Aged, Retrospective Studies.
Abstract
PURPOSE
Febrile neutropenia (FN) is a major risk factor for infection-related morbidity and mortality. The National Comprehensive Cancer Network recommends the prophylactic use of granulocyte-colony stimulating factors (G-CSF), dosed at 5 mcg/kg and rounded to the nearest vial size. A previous medication use evaluation conducted within a multi-hospital healthcare system demonstrated that only 67% of patients were started on appropriate weight-based dosing. The purpose of this study was to evaluate the effect of appropriate weight-based G-CSF dosing in patients on clinical outcomes.
METHODS
A retrospective chart review of patients with acute leukemia or stem cell transplant recipients who received G-CSF from May 2009 to September 2015 was conducted. Patient admissions were reviewed in regards to neutropenia length, incidence of FN, length of stay, and final disposition (alive or deceased). Admissions were divided into one of three weight-based dosing groups of under 5 mcg/kg, recommended 5 mcg/kg within a 10% range, and over 5 mcg/kg which were named under, recommended, and over, respectively.
RESULTS
Ninety-four admissions were included. Average age of this patient population was 58 years old, and the majority of patients were male (53%) and Caucasian (55%). Majority of patients had been diagnosed with acute myeloid leukemia (91%). Data showed average duration of neutropenia was around 10 days regardless if the patient received under 5 mcg/kg, the recommended 5 mcg/kg or over 5 mcg/kg G-CSF (10.1 ± 6.7 days, 8.9 ± 9.2 days, 10.1 ± 9.1 days, respectively). Length of stay was similar for patients regardless of initial G-CSF dose (29.6 ± 16.0 days, 29.1 ± 18.4 days, and 24.5 ± 17.0, respectively). However, the incidence of FN was significantly greater for those who received under 5 mcg/kg of G-CSF (87% for under, 68% for recommended, and 54% for over).
CONCLUSIONS
In this retrospective analysis, variations from the recommended 5 mcg/kg G-CSF dose did not significantly impact length of neutropenia, length of stay, nor mortality. However, patients who received under the 5 mcg/kg of G-CSF dose may be at a greater risk of FN.
DOI: 10.1007/s00520-017-3570-6
PubMed: 28120115
Affiliations:
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Broyles</name><affiliation wicri:level="1"><nlm:affiliation>Methodist University Hospital, 1256 Union Avenue, Memphis, TN, 38104, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Methodist University Hospital, 1256 Union Avenue, Memphis, TN, 38104</wicri:regionArea><wicri:noRegion>38104</wicri:noRegion></affiliation></author><author><name sortKey="C Wheelis, Susan" sort="C Wheelis, Susan" uniqKey="C Wheelis S" first="Susan" last="C Wheelis">Susan C Wheelis</name><affiliation wicri:level="1"><nlm:affiliation>Methodist Le Bonheur Germantown Hospital, 7691 Poplar Avenue, Germantown, TN, 38138, USA. susan.wheelis@mlh.org.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Methodist Le Bonheur Germantown Hospital, 7691 Poplar Avenue, Germantown, TN, 38138</wicri:regionArea><wicri:noRegion>38138</wicri:noRegion></affiliation></author></analytic><series><title level="j">Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer</title><idno type="eISSN">1433-7339</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Body Weight (MeSH)</term><term>Female (MeSH)</term><term>Fever (prevention & control)</term><term>Granulocyte Colony-Stimulating Factor (therapeutic use)</term><term>Humans (MeSH)</term><term>Leukemia, Myeloid, Acute (drug therapy)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Neutropenia (prevention & control)</term><term>Retrospective Studies (MeSH)</term><term>Stem Cell Transplantation (methods)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen (MeSH)</term><term>Facteur de stimulation des colonies de granulocytes (usage thérapeutique)</term><term>Femelle (MeSH)</term><term>Fièvre (prévention et contrôle)</term><term>Humains (MeSH)</term><term>Leucémie aigüe myéloïde (traitement médicamenteux)</term><term>Mâle (MeSH)</term><term>Neutropénie (prévention et contrôle)</term><term>Poids (MeSH)</term><term>Transplantation de cellules souches (méthodes)</term><term>Études rétrospectives (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Granulocyte Colony-Stimulating Factor</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Leukemia, Myeloid, Acute</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Stem Cell Transplantation</term></keywords><keywords scheme="MESH" qualifier="méthodes" xml:lang="fr"><term>Transplantation de cellules souches</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Fever</term><term>Neutropenia</term></keywords><keywords scheme="MESH" qualifier="prévention et contrôle" xml:lang="fr"><term>Fièvre</term><term>Neutropénie</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Leucémie aigüe myéloïde</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Facteur de stimulation des colonies de granulocytes</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Body Weight</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Retrospective Studies</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Femelle</term><term>Humains</term><term>Mâle</term><term>Poids</term><term>Études rétrospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>PURPOSE</b></p><p>Febrile neutropenia (FN) is a major risk factor for infection-related morbidity and mortality. The National Comprehensive Cancer Network recommends the prophylactic use of granulocyte-colony stimulating factors (G-CSF), dosed at 5 mcg/kg and rounded to the nearest vial size. A previous medication use evaluation conducted within a multi-hospital healthcare system demonstrated that only 67% of patients were started on appropriate weight-based dosing. The purpose of this study was to evaluate the effect of appropriate weight-based G-CSF dosing in patients on clinical outcomes.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>A retrospective chart review of patients with acute leukemia or stem cell transplant recipients who received G-CSF from May 2009 to September 2015 was conducted. Patient admissions were reviewed in regards to neutropenia length, incidence of FN, length of stay, and final disposition (alive or deceased). Admissions were divided into one of three weight-based dosing groups of under 5 mcg/kg, recommended 5 mcg/kg within a 10% range, and over 5 mcg/kg which were named under, recommended, and over, respectively.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Ninety-four admissions were included. Average age of this patient population was 58 years old, and the majority of patients were male (53%) and Caucasian (55%). Majority of patients had been diagnosed with acute myeloid leukemia (91%). Data showed average duration of neutropenia was around 10 days regardless if the patient received under 5 mcg/kg, the recommended 5 mcg/kg or over 5 mcg/kg G-CSF (10.1 ± 6.7 days, 8.9 ± 9.2 days, 10.1 ± 9.1 days, respectively). Length of stay was similar for patients regardless of initial G-CSF dose (29.6 ± 16.0 days, 29.1 ± 18.4 days, and 24.5 ± 17.0, respectively). However, the incidence of FN was significantly greater for those who received under 5 mcg/kg of G-CSF (87% for under, 68% for recommended, and 54% for over).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>In this retrospective analysis, variations from the recommended 5 mcg/kg G-CSF dose did not significantly impact length of neutropenia, length of stay, nor mortality. However, patients who received under the 5 mcg/kg of G-CSF dose may be at a greater risk of FN.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" IndexingMethod="Curated" Owner="NLM"><PMID Version="1">28120115</PMID><DateCompleted><Year>2017</Year><Month>10</Month><Day>31</Day></DateCompleted><DateRevised><Year>2018</Year><Month>12</Month><Day>02</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1433-7339</ISSN><JournalIssue CitedMedium="Internet"><Volume>25</Volume><Issue>6</Issue><PubDate><Year>2017</Year><Month>06</Month></PubDate></JournalIssue><Title>Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer</Title><ISOAbbreviation>Support Care Cancer</ISOAbbreviation></Journal><ArticleTitle>Impact of recommended weight-based dosing of granulocyte-colony stimulating factors in acute leukemia and stem cell transplant patients.</ArticleTitle><Pagination><MedlinePgn>1853-1858</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1007/s00520-017-3570-6</ELocationID><Abstract><AbstractText Label="PURPOSE">Febrile neutropenia (FN) is a major risk factor for infection-related morbidity and mortality. The National Comprehensive Cancer Network recommends the prophylactic use of granulocyte-colony stimulating factors (G-CSF), dosed at 5 mcg/kg and rounded to the nearest vial size. A previous medication use evaluation conducted within a multi-hospital healthcare system demonstrated that only 67% of patients were started on appropriate weight-based dosing. The purpose of this study was to evaluate the effect of appropriate weight-based G-CSF dosing in patients on clinical outcomes.</AbstractText><AbstractText Label="METHODS">A retrospective chart review of patients with acute leukemia or stem cell transplant recipients who received G-CSF from May 2009 to September 2015 was conducted. Patient admissions were reviewed in regards to neutropenia length, incidence of FN, length of stay, and final disposition (alive or deceased). Admissions were divided into one of three weight-based dosing groups of under 5 mcg/kg, recommended 5 mcg/kg within a 10% range, and over 5 mcg/kg which were named under, recommended, and over, respectively.</AbstractText><AbstractText Label="RESULTS">Ninety-four admissions were included. Average age of this patient population was 58 years old, and the majority of patients were male (53%) and Caucasian (55%). Majority of patients had been diagnosed with acute myeloid leukemia (91%). Data showed average duration of neutropenia was around 10 days regardless if the patient received under 5 mcg/kg, the recommended 5 mcg/kg or over 5 mcg/kg G-CSF (10.1 ± 6.7 days, 8.9 ± 9.2 days, 10.1 ± 9.1 days, respectively). Length of stay was similar for patients regardless of initial G-CSF dose (29.6 ± 16.0 days, 29.1 ± 18.4 days, and 24.5 ± 17.0, respectively). However, the incidence of FN was significantly greater for those who received under 5 mcg/kg of G-CSF (87% for under, 68% for recommended, and 54% for over).</AbstractText><AbstractText Label="CONCLUSIONS">In this retrospective analysis, variations from the recommended 5 mcg/kg G-CSF dose did not significantly impact length of neutropenia, length of stay, nor mortality. However, patients who received under the 5 mcg/kg of G-CSF dose may be at a greater risk of FN.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>K Hockings</LastName><ForeName>Jennifer</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Methodist University Hospital, 1256 Union Avenue, Memphis, TN, 38104, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>K Owolabi</LastName><ForeName>Diwura</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Methodist University Hospital, 1256 Union Avenue, Memphis, TN, 38104, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Broyles</LastName><ForeName>Joyce E</ForeName><Initials>JE</Initials><AffiliationInfo><Affiliation>Methodist University Hospital, 1256 Union Avenue, Memphis, TN, 38104, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>C Wheelis</LastName><ForeName>Susan</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Methodist Le Bonheur Germantown Hospital, 7691 Poplar Avenue, Germantown, TN, 38138, USA. susan.wheelis@mlh.org.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2017</Year><Month>01</Month><Day>25</Day></ArticleDate></Article><MedlineJournalInfo><Country>Germany</Country><MedlineTA>Support Care Cancer</MedlineTA><NlmUniqueID>9302957</NlmUniqueID><ISSNLinking>0941-4355</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>143011-72-7</RegistryNumber><NameOfSubstance UI="D016179">Granulocyte Colony-Stimulating Factor</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D001835" MajorTopicYN="N">Body Weight</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005334" MajorTopicYN="N">Fever</DescriptorName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016179" MajorTopicYN="N">Granulocyte Colony-Stimulating Factor</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015470" MajorTopicYN="N">Leukemia, Myeloid, Acute</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009503" MajorTopicYN="N">Neutropenia</DescriptorName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D033581" MajorTopicYN="N">Stem Cell Transplantation</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">Febrile neutropenia</Keyword><Keyword MajorTopicYN="Y">Granulocyte-colony stimulating factors</Keyword><Keyword MajorTopicYN="Y">Leukemia</Keyword><Keyword MajorTopicYN="Y">Stem cell transplant</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2016</Year><Month>09</Month><Day>02</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2017</Year><Month>01</Month><Day>09</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2017</Year><Month>1</Month><Day>26</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2017</Year><Month>11</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2017</Year><Month>1</Month><Day>26</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">28120115</ArticleId><ArticleId IdType="doi">10.1007/s00520-017-3570-6</ArticleId><ArticleId IdType="pii">10.1007/s00520-017-3570-6</ArticleId></ArticleIdList><ReferenceList><Reference><Citation>J Natl Cancer Inst. 2011 Jun 22;103(12):979-82</Citation><ArticleIdList><ArticleId IdType="pubmed">21670423</ArticleId></ArticleIdList></Reference><Reference><Citation>Pediatr Infect Dis J. 1994 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Broyles</name><name sortKey="C Wheelis, Susan" sort="C Wheelis, Susan" uniqKey="C Wheelis S" first="Susan" last="C Wheelis">Susan C Wheelis</name><name sortKey="K Owolabi, Diwura" sort="K Owolabi, Diwura" uniqKey="K Owolabi D" first="Diwura" last="K Owolabi">Diwura K Owolabi</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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