Neutropenia Flashcards
Neutropenia is characterised by a low neutrophil count (absolute neutrophil count less than ____________)
1.5 x 10^9/litre
Neutropenia is a risk factor for the development of ______________, especially in patients receiving high-intensity chemotherapy regimens
infection and sepsis
Neutropenia is a risk factor for the development of infection and sepsis, especially in patients receiving _______________
high-intensity chemotherapy regimens
___________________ stimulates the production of neutrophils and may reduce the duration of chemotherapy-induced neutropenia and thereby reduce the incidence of associated febrile neutropenia
Recombinant human granulocyte-colony stimulating factor (rhG-CSF); there is as yet no evidence that it improves overall survival
Granulocyte-colony stimulating factors include … (4)
Drugs ending in “grastim” ie GRAnulocyte STIMulating factors
- filgrastim
- lenograstim
- pegfilgrastim
- lipegfilgrastim
Pegfilgrastim and lipegfilgrastim are polyethylene glycol-conjugated (‘___________’) derivatives of filgrastim, which are longer-acting forms of filgrastim due to decreased renal clearance
pegylated
Pegfilgrastim and lipegfilgrastim are polyethylene glycol-conjugated (‘pegylated’) derivatives of filgrastim, which are ___________-acting forms of filgrastim due to ____________
longer
decreased renal clearance
_____________ (unglycosylated rhG-CSF) and _____________ (glycosylated rhG-CSF) have similar effects; both have been used in a variety of clinical settings for the treatment of neutropenia
Filgrastim
lenograstim
How are granulocyte-colony stimulating factors (G-CSF) administered?
S/C
GCS-Fs should be prescribed with caution in which patients? (4)
- Malignant myeloid conditions
- Pre-malignant myeloid conditions
- Risk of splenomegaly and rupture spleen size should be monitored)
- Sickle-cell disease
GCS-F stimulates the production of ____________
Neutrophils
Following the administration of GCS-F, there have been reports of pulmonary infiltrates leading to ________________—patients with a recent history of pulmonary infiltrates or pneumonia may be at higher risk.
acute respiratory distress syndrome
Following the administration of GCS-F, there have been reports of pulmonary infiltrates leading to acute respiratory distress syndrome—patients with a recent history of ________________ or ________________ may be at higher risk.
pulmonary infiltrates
pneumonia
Patients who have been on filgrastim for more than 6 months should be monitored for _________________
Osteoporotic bone disease; monitor bone density
Common side effects of GCS-Fs include … (10)
- Arthralgia, osteoporosis
- Cutaneous vasculitis
- Dyspnea
- Hemoptysis, hemorrhage
- Headache
- Hypersensitivity, rash
- Leukocytosis
- Pain
- Spleen abnormalities and hepatomegaly
- Thrombocytopenia
Treatment with GCS-F should be withdrawn in patients who develop signs of ______________
pulmonary infiltration
Are GCS-F drugs safe to use in pregnancy and breastfeeding?
Avoid during both
What are the monitoring requirements for patients taking GCS-F drugs? (2)
- FBC should be monitored including differential WCC and PLT counts
- Spleen size should be monitored during treatment due to risk of splenomegaly and rupture
*plus regular morphological and cytogenetic bone marrow examinations in severe congenital neutropenia due to possible risk of myelodysplastic syndromes and leukemia
Patients with severe congenital neutropenia who are taking filgrastim are at an increased risk of developing ______________ or ______________
Myelodysplastic syndrome
Leukemia
GCS-F drugs are contraindicated in patients with ________________ or ______________
Severe congenital neutropenia who develop leukemia
Have evidence of leukemic evolution
