Neutropenia Flashcards
What is the most common dose-limiting toxicity of chemotherapy?
bone marrow suppression
Definition: the lowest value the blood counts fall during a cycle of chemotherapy
nadir
When does the nadir generally occur?
10 - 14 days after chemotherapy
When do the blood counts usually recover?
3 - 4 weeks after chemotherapy
What other factors can affect myelosuppresion? (3)
previous chemotherapy; previous radiation therapy; direct bone marrow involvement
What ANC defines severe neutropenia?
ANC < 0.5 x 10^3/uL
What findings define febrile neutropenia? (2)
ANC < 0.5 x 10^3/uL & oral temperature above 100.4 F for at least an hour OR single oral temperature above 101 F
What is the only reliable indicator of infection in neutropenia?
fever
What is used as prophylaxis for febrile neutropenia?
Colony stimulating factors (CSF)
What patient populations should receive primary prophylaxis for febrile neutropenia? (2)
high risk patients; those on chemotherapy with a greater than 20% risk of causing neutropenia
What patient population should receive secondary prophylaxis for febrile neutropenia?
patients who experienced a neutropenic complication from a previous cycle of chemotherapy
Should you use CSF to treat febrile neutropenia and why?
No (only decreases hospitalization stay by 1 day, cost outweighs benefit)
What are the two CSF options?
filgastim; pegfilgastim
What do you need to remember about filgastim?
causes a dose-dependent increase in neutrophil count, rapid drop in WBC and neutrophil count follwing discontinuation
What do you need to remember about pegfilgastim?
has a longer half-life than filgastim
