Characterization of neutropenic fever in patients receiving first-line adjuvant chemotherapy for epithelial ovarian cancer

Sharma, Sameer; Rezai, Keyvan; Driscoll, Deborah L.; Odunsi, Kunle; Lele, Shashikant

doi:10.1016/j.ygyno.2006.02.012

Cited by 12 publications

(12 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Shama et al . 12 reported febrile neutropenia in 12% patients with epithelial ovarian cancer during first-line adjuvant chemotherapy and concluded that the rate of febrile neutropenia was higher than reported previously. Laskey et al .…”

Section: Discussionmentioning

confidence: 79%

“…Some reports comprehensively studied febrile neutropenia in patients with ovarian cancer. In these reports, only patients receiving first-line chemotherapy were included, and no patients with recurrent disease were included 12 , 13 . To the best of our knowledge, the last comprehensive study of febrile neutropenia in patients with gynecologic malignancy was published in 1996 14 .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Chemotherapy-induced neutropenia and febrile neutropenia in patients with gynecologic malignancy

et al. 2015

View full text Add to dashboard Cite

Chemotherapy-induced neutropenia is a common complication in cancer treatment. In this study, we investigated chemotherapy-induced neutropenia that was recently detected in all patients with gynecologic malignancy. Between January 2009 and December 2011, we examined cases of chemotherapy-induced neutropenia reported in our hospital. We analyzed the incidence and clinical features of chemotherapy-induced neutropenia and febrile neutropenia in patients with gynecologic malignancy. During the study period, we administered over 1614 infusions (29 regimens) to 291 patients. The median age of the patients was 60 years (range 24–84 years). Chemotherapy-induced neutropenia occurred in 147 (50.5%) patients over 378 (23.4%) chemotherapy cycles. Febrile neutropenia occurred in 20 (6.9%) patients over 25 (1.5%) cycles. The mean duration of neutropenia and fever was 3.6 days (range 1–12 days) and 3.4 days (range 1–9 days), respectively. The source of fever was unexplained by examination or cultures in 14 (56.0%) cycles. There were two cases of neutropenia-related death. Chemotherapy-induced neutropenia was associated with older age (over 70 years) (P<0.0001), less than five previous chemotherapy cycles (P=0.02), disseminated disease (P=0.03), platinum-based regimens (P<0.0001), taxane-containing regimens (P<0.0001), and combined therapy (P<0.0001). Febrile neutropenia was associated with poor performance status (P<0.0001), no previous chemotherapy (P<0.05), disseminated disease (P<0.0001), and distant metastatic disease (P=0.03). Neither chemotherapy-induced neutropenia nor febrile neutropenia was associated with bone marrow metastases or previous radiotherapy. By identifying risk factors for febrile neutropenia, such as performance status, no previous chemotherapy, disseminated disease, and distant metastatic disease, the safe management of chemotherapy-induced neutropenia may be possible in patients with gynecologic malignancy.

show abstract

Section: Discussionmentioning

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Chemotherapy-induced neutropenia and febrile neutropenia in patients with gynecologic malignancy

et al. 2015

View full text Add to dashboard Cite

show abstract

“…21 Myelosuppression resulting in neutropenic fever and infection are frequent chemotherapy-induced toxicities associated with hospitalizations. 22,23 In a study of 125 patients undergoing first-line adjuvant therapy for ovarian cancer, 12% developed neutropenic fever. 24 Data on either complicated myelotoxicity or serious neutropenic toxicity were available in a few studies.…”

Section: Discussionmentioning

confidence: 99%

Risk of Hospitalizations Associated With Adverse Effects of Chemotherapy in a Large Community-Based Cohort of Elderly Women With Ovarian Cancer

Nurgalieva¹,

Liu²,

Du³

2009

International Journal of Gynecological Cancer

View full text Add to dashboard Cite

show abstract

“…Outside of clinical trials, there is limited data on the incidence of FN in patients with advanced EOC, especially in the taxane era. Recently, Sharma et al (15) published a series of 125 patients treated primarily with taxane/platinum‐based chemotherapy for advanced EOC and found a 12% incidence of FN. Significant risk factors associated with the development of FN were radicality of initial surgery and advanced‐stage disease.…”

Section: Discussionmentioning

confidence: 99%

Pegfilgrastim for the prevention of febrile neutropenia in patients with epithelial ovarian carcinoma—a cost-effectiveness analysis

Numnum

Kimball

Rocconi

et al. 2007

Int J Gynecol Cancer

View full text Add to dashboard Cite

The objective is to assess the cost-effectiveness of pegfilgrastim for the prevention of hospitalization due to febrile neutropenia (FN) in patients with epithelial ovarian carcinoma (EOC) receiving taxane/platinum-based chemotherapy. A decision analysis model evaluated a hypothetical cohort of 10,000 patients receiving six cycles of taxane/platinum-based chemotherapy for EOC. Three strategies were analyzed for the prevention of hospitalization due to FN: 1) dose modifications and delays after a hospitalization for FN without the use of granulocyte-colony stimulating factors (G-CSF) (NO G-CSF); 2) all patients receive G-CSF with each chemotherapy cycle (1 degrees PROPHYLAXIS); 3) patients receive G-CSF for all subsequent chemotherapy cycles after a hospitalization for FN (2 degrees PROPHYLAXIS). The model was applied to two patient populations: 1) an average-risk population (FN hospitalization rate = 5%); 2) a high-risk population (FN hospitalization rate = 16%). Using baseline assumptions in an average-risk population, NO G-CSF was the least expensive strategy with a cost of $68 million and resulted in 2,860 hospitalizations for FN. 2 degrees PROPHYLAXIS resulted in 141 fewer hospitalizations than NO G-CSF at a cost of $76,288 per hospitalization prevented. 1 degrees PROPHYLAXIS was the most effective and resulted in 1,689 fewer hospitalizations for FN compared to NO G-CSF at a cost of $47,343 per hospitalization prevented. When this model is applied to a high-risk patient population, 1 degrees PROPHYLAXIS is more effective and less expensive than both NO G-CSF and 2 degrees PROPHYLAXIS. We conclude that in average-risk patients receiving chemotherapy for EOC the use of pegfilgrastim is effective at reducing hospitalizations due to FN, but at a significant cost. However, in high-risk patients, primary prophylaxis is the only cost-effective strategy and should be strongly considered.

show abstract

Characterization of neutropenic fever in patients receiving first-line adjuvant chemotherapy for epithelial ovarian cancer

Cited by 12 publications

References 21 publications

Chemotherapy-induced neutropenia and febrile neutropenia in patients with gynecologic malignancy

Chemotherapy-induced neutropenia and febrile neutropenia in patients with gynecologic malignancy

Risk of Hospitalizations Associated With Adverse Effects of Chemotherapy in a Large Community-Based Cohort of Elderly Women With Ovarian Cancer

Pegfilgrastim for the prevention of febrile neutropenia in patients with epithelial ovarian carcinoma—a cost-effectiveness analysis

Contact Info

Product

Resources

About