Chemotherapy limiting neutropenia. Is prevention required?

Abstract

Neutropenia is the most common hematologic toxicity of chemotherapy. Severe and prolonged neutropenia can cause treatment delay and dose reduction. Clinical studies indicate that reducing the relative dose intensity of regimens harms treatment outcomes, especially in breast, ovarian, and pancreatic cancers. Therefore, screening of patients at high risk of neutropenia that limits planned chemotherapy is of practical importance. Unfortunately, most clinical studies indicate only the incidence of myelotoxicity with each chemotherapy regimen, and only a few have analyzed the potential risks associated with this complication. That is significant importance in highly chemotherapy-sensitive malignancies. Such patients often receive dose intense and dose dens chemotherapy. The risk of severe neutropenia in such patients and failure to adhere to planned chemotherapy may reduce the chances of cure. Currently, there is no consensus among oncologists on the management strategy for patients with neutropenia limiting chemotherapy. This topic is a worldwide discussion. The article presents scientific evidence and clinical studies dedicated to this problem. A general analysis of clinical data and experience of oncologists will allow the medical community to develop approaches to prevent this complication.

Keywords

• neutropenia
• febrile neutropenia
• granulocyte colony-stimulating factor
• relative dose intensity