Neutropenia, Thrombocytopenia, Anemia

Question 1

Neutropenia:

Q: definition
Q: sx’s
Q: prevention
Q: treatment

Answer 1

1. decrease in WBCs (decrease in immune response)
2. fever/ infection
3. G-CSFs in high risk pts
4. Antibiotics (if febrile)

Question 2

Thrombocytopenia:

Q: definition
Q: sx’s
Q: treatment

Answer 2

1. low platelets (bleeding risk/uncontrolled bleeding)
2. bleeding
3. platelet transfusion if platelets < 10,000 cells/mm3

Question 3

Anemia:

Q: definition
Q: sx’s
Q: treatment

Answer 3

1. low RBCs, Hgb, Hct
2. weakness/ fatigue
3. can resolve on its own
   RBC transfusion in symptomatic pts (Hgb < 10 g/dL and a minimum of @ least 2 additional mo of chemo)
   Erythropoiesis-stimulating agent (ESA) in select patients

Question 4

list ESA agents for anemia

Answer 4

Epoetin alpha (Epogen, Procrit)

Darbepoetin alpha (Aranesp): Longer acting

Question 5

who are ESAs recommended for and why

Answer 5

recommended for PALLIATION only and NOT for pts receiving chemo for CURATIVE INTENT

ESAs can SHORTEN SURVIVAL. and INCREASE TUMOR PROGRESSION