The importance of the prevention of treatment induced neutropenia in patients with malignant neoplasms of the head and neck

Abstract

Hematological toxicity is the most common complication of chemotherapy. The most dangerous manifestation of hematological toxicity is febrile neutropenia (FN). FN reduces survival, increases the risk of death, the frequency of infectious complications, hospitalizations, the cost of treatment. The risk of FN should be assessed before the beginning of the therapy, using the general algorithm from the protocol to prevent FN applying the granulocyte colony-stimulating factors (G-CSF). G-CSF for the prevention is required throughout all cycles of myelosuppressive therapy. For the prevention of FN, the most effective is the use of PEGylated G-CSF. Patients with head and neck squamous cell carcinoma, receiving the TPF or DCF regimen, combined with docetaxel and cisplatin, are included in the group of routine primary prophylaxis for neutropenia. In case of developing 34 grade FN in these patients, the use of PEGylated G-CSF (empegfilgrastim) is preferable.

Keywords

• malignant neoplasms of the head and neck
• hematological toxicity
• myelotoxicity
• febrile neutropenia
• granulocyte colony-stimulating factors
• filgrastim
• empegfilgrastim
• prevention