Chemotherapy-Induced Neutropenia and Febrile Neutropenia in the US: A Beast of Burden That Needs to Be Tamed?
Adult
Aged
Antineoplastic Agents
/ therapeutic use
Antineoplastic Combined Chemotherapy Protocols
Biosimilar Pharmaceuticals
/ therapeutic use
Chemotherapy-Induced Febrile Neutropenia
/ epidemiology
Child
Granulocyte Colony-Stimulating Factor
/ therapeutic use
Humans
Neoplasms
/ drug therapy
Pandemics
COVID-19 Drug Treatment
US
costs and cost analysis
febrile neutropenia
hospitalization
mortality
Journal
The oncologist
ISSN: 1549-490X
Titre abrégé: Oncologist
Pays: England
ID NLM: 9607837
Informations de publication
Date de publication:
05 08 2022
05 08 2022
Historique:
received:
14
12
2020
accepted:
24
02
2022
pubmed:
14
5
2022
medline:
10
8
2022
entrez:
13
5
2022
Statut:
ppublish
Résumé
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.
Identifiants
pubmed: 35552754
pii: 6584944
doi: 10.1093/oncolo/oyac074
pmc: PMC9355811
doi:
Substances chimiques
Antineoplastic Agents
0
Biosimilar Pharmaceuticals
0
Granulocyte Colony-Stimulating Factor
143011-72-7
Types de publication
Journal Article
Review
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
625-636Informations de copyright
© The Author(s) 2022. Published by Oxford University Press.
Références
N Engl J Med. 2005 Jun 2;352(22):2302-13
pubmed: 15930421
Support Care Cancer. 2015 Mar;23(3):615-7
pubmed: 25556610
Ann Hematol. 2018 Apr;97(4):573-584
pubmed: 29288428
Ann Intern Med. 2007 May 1;146(9):657-65
pubmed: 17470834
BioDrugs. 2020 Jun;34(3):255-263
pubmed: 32232676
J Manag Care Spec Pharm. 2019 Jan;25(1):94-101
pubmed: 30084301
Eur J Epidemiol. 2004;19(6):563-5
pubmed: 15330129
J Oncol Pract. 2017 Jun;13(6):e552-e561
pubmed: 28437150
Oncologist. 2007 Apr;12(4):478-83
pubmed: 17470690
Cancer. 2005 May 1;103(9):1916-24
pubmed: 15751024
Arch Intern Med. 2005 Apr 25;165(8):869-74
pubmed: 15851637
Support Care Cancer. 2013 May;21(5):1487-95
pubmed: 23443617
Ann Oncol. 2016 Sep;27(suppl 5):v111-v118
pubmed: 27664247
Am J Hematol. 2003 Apr;72(4):248-54
pubmed: 12666135
Support Care Cancer. 2015 Feb;23(2):371-5
pubmed: 25103678
BMC Nurs. 2005 Jul 08;4:4
pubmed: 16004611
Am J Health Syst Pharm. 2015 Apr 15;72(8):619-31
pubmed: 25825185
Br J Cancer. 2011 Aug 23;105(5):612-7
pubmed: 21811253
Cancer Med. 2017 Dec;6(12):2814-2821
pubmed: 29058375
Pediatr Blood Cancer. 2015 Mar;62(3):490-5
pubmed: 25345994
J Natl Compr Canc Netw. 2020 Sep 1;:1-4
pubmed: 32871558
Clin Lung Cancer. 2018 Mar;19(2):e163-e169
pubmed: 29233611
J Clin Oncol. 2018 May 10;36(14):1443-1453
pubmed: 29461916
Cancer Med. 2014 Apr;3(2):434-44
pubmed: 24706592
J Oncol Pharm Pract. 2017 Jun;23(4):278-283
pubmed: 28077045
Clin Infect Dis. 2011 Feb 15;52(4):e56-93
pubmed: 21258094
Cancer. 2004 Jan 15;100(2):228-37
pubmed: 14716755
BMC Cancer. 2015 May 10;15:388
pubmed: 25957578
J Clin Oncol. 2018 Oct 20;36(30):3043-3054
pubmed: 30179565
J Pediatr Hematol Oncol. 2017 Jan;39(1):e1-e7
pubmed: 27918351
Clin J Oncol Nurs. 2014 Aug;18(4):426-31
pubmed: 25095295
PLoS One. 2019 May 23;14(5):e0216835
pubmed: 31120893
Eur J Cancer Care (Engl). 2008 Jan;17(1):19-25
pubmed: 18181887
Ann Emerg Med. 2016 Dec;68(6):706-711
pubmed: 26921969
Adv Ther. 2020 Aug;37(8):3606-3618
pubmed: 32642965
J Oncol Pract. 2015 Jan;11(1):47-54
pubmed: 25491042
Pediatr Hematol Oncol. 2016 Feb;33(1):39-48
pubmed: 26900730
Ann Emerg Med. 2017 Jun;69(6):755-764
pubmed: 28041827
J Clin Oncol. 2013 Feb 20;31(6):794-810
pubmed: 23319691
Support Care Cancer. 2020 Jan;28(1):113-122
pubmed: 30993450
J Med Econ. 2013;16(6):720-35
pubmed: 23452298
Semin Hematol. 2013 Jul;50(3):198-206
pubmed: 23953336
J Clin Oncol. 2000 Aug;18(16):3038-51
pubmed: 10944139
Curr Opin Support Palliat Care. 2009 Sep;3(3):207-12
pubmed: 19550332
P T. 2016 Dec;41(12):765-768
pubmed: 27990078
Cancer. 2006 May 15;106(10):2258-66
pubmed: 16575919
J Clin Oncol. 2015 Feb 10;33(5):465-71
pubmed: 25559804
J Pediatr. 2018 Nov;202:231-237.e3
pubmed: 30029861
Am J Hematol. 2016 Oct;91(10):1002-7
pubmed: 27356783
Arch Intern Med. 1992 Jul;152(7):1475-80
pubmed: 1627027
Arch Intern Med. 1999 Feb 22;159(4):369-74
pubmed: 10030310
Ann Oncol. 2006 Mar;17(3):507-14
pubmed: 16322116
J Clin Oncol. 2015 Oct 1;33(28):3199-212
pubmed: 26169616
Cancer Manag Res. 2018 Oct 17;10:4591-4602
pubmed: 30410395