Cancer Treatment Today

Standard guidelines recommend prophylactic Neulasta or Neupogen for patients who are treated with chemotherapy regimens that produce a greater than 20% risk of febrile neutropenia. These guidelines do not apply to the elderly. Elderly patients are at a higher risk of febrile neutropenia following chemotherapy, with worse morbidity and mortality rates. However, good prospective trial data are lacking with respect to elderly cancer patients due to

Many chemotherapeutic drugs cause neutropenia and guidelines now uniformly recommend G-CSF(granulocyte growth stimulating factors) prophylactically and therapeutically for chemotherapy. However, non-chemo drugs can also cause neutropenia. Among them are bcr-abl directed drugs used for CML, such as Gleevec. Depending on the stage, up to 70% of the patients treated with imatinib for CML experience an NCI grade 3 or 4 neutropenia or thrombocytopenia

Mozobil is a new drug designed to mobilize stem cells from the bone marrow into the bloodstream, where they can be collected. Previous alkylation therapy, radiotherapy and low collection day platelet count are predictive of poor collection yields. Neupogen, which is commonly given prior to stem cell harvesting, stimulates the body to make white blood cells. When given together, Mozobil and Neupogen have been shown to increase harvest efficiency prior

Myeloid growth factors granulocyte-colony stimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor (GM-CSF) have been extensively studied in acute leukemias. Whether administered before, during, or after chemotherapy for acute myeloid and acute lymphoblastic leukemias, these agents reduce the duration of neutropenia and appear to be safe and well tolerated. Despite consistently demonstrating a shorter duration of neutropenia,

The issue in is whether the docetaxel/ cyclophashamide regimen has a febrile neutropenia rate of 20% or more when used in the usual manner in adjuvant treatmetn of breast cancer. The issue is solely whether the docetaxel/ cyclophashamide regimen has a febrile neutrropenai rate of 20% or more when used in the usual manner in adjuvant treatment of breast cancer. The original Journal of Clinical Onology paper(Dec 1 206)reported a febrile nutropenia

  The use of G-CSF after the administration of chemotherapy may be in several settings: “Primary prophylaxis,” when neutropenia is expected to occur following a course of chemotherapy, but the patient has never experienced it. “Secondary prophylaxis,” when the patient had a neutropenic fever in a previous course of similar chemotherapy and is thus expected to do so again. “Supportive” in the attempt to shorten the duration of severe

Neutropenia has been well reported with Rituxan in CLL. In these reports it ws usually associated with agressive regimens that incorpoorted Rituxan. The use of intensive primary chemotherapy regimen was a risk factor. Neutropenia was generally self-limited and not associated with severe infections. I did not find any reports of using G-CSF to treat this condition and in the absence of dicumented infection, it may not be of any benefit. Since an immunologic

Severe congenital neutropenia (SCN) is a constellation of syndromes consisting of arrested myeloid development resulting in neutropenia. The mainstay of treatment is G-CSF. It is not, however, a curative treatment. Approximately 90% of patients respond to GCSF administration with a subsequent decrease in sepsis-related mortality to almost 1% per year during the first decade of life, with a cumulative incidence of 21% of progression to acute leukemia

Severe chronic neutropenia is a general term that applies to both congenital and acquired cases. Kostmann syndrome is a subtype of chronic neutropenia with onset in early childhood with an autosomal recessive pattern of development. It can have an immune basis.  The mainstay of treatment is G-CSF and the member has done well on it. It is not, however, a curative treatment. Approximately 90% of patients respond to GCSF administration with a subsequent

NCCN, ASCO and ASH guidelines recommend routine use of Neulasta® or Neupogen (filgrastim) for patients with an overall risk of FN of 20% or greater. Previous studies have suggested that these drugs can reduce the incidence of hospitalizations, decrease Febrile Neutropenia and allow better delivery of protocol doses of chemotherapy. The supportive data was generated from 8 randomized clinical trials and 3 observational studies conducted between 1998