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Chemotherapy-Induced Neutropenia and Febrile Neutropenia in the US: A Beast of Burden That Needs to Be Tamed?

Publication ,  Journal Article
Boccia, R; Glaspy, J; Crawford, J; Aapro, M
Published in: Oncologist
August 5, 2022

Neutropenia and febrile neutropenia (FN) are common complications of myelosuppressive chemotherapy. This review provides an up-to-date assessment of the patient and cost burden of chemotherapy-induced neutropenia/FN in the US, and summarizes recommendations for FN prophylaxis, including the interim guidance that was recommended during the coronavirus disease 2019 (COVID-19) pandemic. This review indicates that neutropenia/FN place a significant burden on patients in terms of hospitalizations and mortality. Most patients with neutropenia/FN presenting to the emergency department will be hospitalized, with an average length of stay of 6, 8, and 10 days for elderly, pediatric, and adult patients, respectively. Reported in-hospital mortality rates for neutropenia/FN range from 0.4% to 3.0% for pediatric patients with cancer, 2.6% to 7.0% for adults with solid tumors, and 7.4% for adults with hematologic malignancies. Neutropenia/FN also place a significant cost burden on US healthcare systems, with average costs per neutropenia/FN hospitalization estimated to be up to $40 000 for adult patients and $65 000 for pediatric patients. Evidence-based guidelines recommend prophylactic granulocyte colony-stimulating factors (G-CSFs), which have been shown to reduce FN incidence while improving chemotherapy dose delivery. Availability of biosimilars may improve costs of care. Efforts to decrease hospitalizations by optimizing outpatient care could reduce the burden of neutropenia/FN; this was particularly pertinent during the COVID-19 pandemic since avoidance of hospitalization was needed to reduce exposure to the virus, and resulted in the adaptation of recommendations to prevent FN, which expanded the indications for G-CSF and/or lowered the threshold of use to >10% risk of FN.

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Published In

Oncologist

DOI

EISSN

1549-490X

Publication Date

August 5, 2022

Volume

27

Issue

8

Start / End Page

625 / 636

Location

England

Related Subject Headings

  • Pandemics
  • Oncology & Carcinogenesis
  • Neoplasms
  • Humans
  • Granulocyte Colony-Stimulating Factor
  • Child
  • Chemotherapy-Induced Febrile Neutropenia
  • COVID-19 Drug Treatment
  • Biosimilar Pharmaceuticals
  • Antineoplastic Combined Chemotherapy Protocols
 

Citation

APA
Chicago
ICMJE
MLA
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Boccia, R., Glaspy, J., Crawford, J., & Aapro, M. (2022). Chemotherapy-Induced Neutropenia and Febrile Neutropenia in the US: A Beast of Burden That Needs to Be Tamed? Oncologist, 27(8), 625–636. https://doi.org/10.1093/oncolo/oyac074
Boccia, Ralph, John Glaspy, Jeffrey Crawford, and Matti Aapro. “Chemotherapy-Induced Neutropenia and Febrile Neutropenia in the US: A Beast of Burden That Needs to Be Tamed?Oncologist 27, no. 8 (August 5, 2022): 625–36. https://doi.org/10.1093/oncolo/oyac074.
Boccia R, Glaspy J, Crawford J, Aapro M. Chemotherapy-Induced Neutropenia and Febrile Neutropenia in the US: A Beast of Burden That Needs to Be Tamed? Oncologist. 2022 Aug 5;27(8):625–36.
Boccia, Ralph, et al. “Chemotherapy-Induced Neutropenia and Febrile Neutropenia in the US: A Beast of Burden That Needs to Be Tamed?Oncologist, vol. 27, no. 8, Aug. 2022, pp. 625–36. Pubmed, doi:10.1093/oncolo/oyac074.
Boccia R, Glaspy J, Crawford J, Aapro M. Chemotherapy-Induced Neutropenia and Febrile Neutropenia in the US: A Beast of Burden That Needs to Be Tamed? Oncologist. 2022 Aug 5;27(8):625–636.

Published In

Oncologist

DOI

EISSN

1549-490X

Publication Date

August 5, 2022

Volume

27

Issue

8

Start / End Page

625 / 636

Location

England

Related Subject Headings

  • Pandemics
  • Oncology & Carcinogenesis
  • Neoplasms
  • Humans
  • Granulocyte Colony-Stimulating Factor
  • Child
  • Chemotherapy-Induced Febrile Neutropenia
  • COVID-19 Drug Treatment
  • Biosimilar Pharmaceuticals
  • Antineoplastic Combined Chemotherapy Protocols