Cancer Biology & Medicine (Nov 2020)
Current management of chemotherapy-induced neutropenia in adults: key points and new challenges
- Yi Ba,
- Yuankai Shi,
- Wenqi Jiang,
- Jifeng Feng,
- Ying Cheng,
- Li Xiao,
- Qingyuan Zhang,
- Wensheng Qiu,
- Binghe Xu,
- Ruihua Xu,
- Bo Shen,
- Zhiguo Luo,
- Xiaodong Xie,
- Jianhua Chang,
- Mengzhao Wang,
- Yufu Li,
- Yuerong Shuang,
- Zuoxing Niu,
- Bo Liu,
- Jun Zhang,
- Li Zhang,
- Herui Yao,
- Conghua Xie,
- Huiqiang Huang,
- Wangjun Liao,
- Gongyan Chen,
- Xiaotian Zhang,
- Hanxiang An,
- Yanhong Deng,
- Ping Gong,
- Jianping Xiong,
- Qinghua Yao,
- Xin An,
- Cheng Chen,
- Yanxia Shi,
- Jialei Wang,
- Xiaohua Wang,
- Zhiqiang Wang,
- Puyuan Xing,
- Sheng Yang,
- Chenfei Zhou
Affiliations
- Yi Ba
- Department of Gastrointestinal Medical Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin’s Clinical Research Center for Cancer, Tianjin 300060, China
- Yuankai Shi
- Department of Medical Oncology, National Cancer Center, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
- Wenqi Jiang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
- Jifeng Feng
- Department of Medical Oncology, Jiangsu Cancer Hospital, Nanjing 210009, China
- Ying Cheng
- Department of Oncology, Jilin Province Cancer Hospital, Changchun 130012, China
- Li Xiao
- Department of Oncology, Zhongshan Hospital Affiliated to Xiamen University, Xiamen 361004, China
- Qingyuan Zhang
- Department of Oncology, Cancer Hospital Harbin Medical University, Harbin 150081, China
- Wensheng Qiu
- Department of Oncology, Affiliated Hospital of Qingdao University, Qingdao 266003, China
- Binghe Xu
- Department of Medical Oncology, National Cancer Center, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
- Ruihua Xu
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
- Bo Shen
- Department of Medical Oncology, Jiangsu Cancer Hospital, Nanjing 210009, China
- Zhiguo Luo
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
- Xiaodong Xie
- Department of Oncology, General Hospital of Shenyang Military Region, Shenyang 110016, China
- Jianhua Chang
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
- Mengzhao Wang
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Beijing 100730, China
- Yufu Li
- Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China
- Yuerong Shuang
- Lymphoma and Myeloma Department, Jiangxi Cancer Hospital, Nanchang 330029, China
- Zuoxing Niu
- Department of Medical Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan 250117, China
- Bo Liu
- Department of Medical Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan 250117, China
- Jun Zhang
- Department of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
- Li Zhang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
- Herui Yao
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
- Conghua Xie
- Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan 430070, China
- Huiqiang Huang
- Department of Medical Oncology, National Cancer Center, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
- Wangjun Liao
- Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
- Gongyan Chen
- Department of Oncology, Cancer Hospital Harbin Medical University, Harbin 150081, China
- Xiaotian Zhang
- Department of Gastrointestinal Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China
- Hanxiang An
- Department of Medical Oncology, Xiang’an Hospital of Xiamen University, Xiamen 361101, China
- Yanhong Deng
- Department of Medical Oncology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, China
- Ping Gong
- Department of Oncology, The First Affiliated Hospital, Shihezi University School of Medicine, Shihezi 832000, China
- Jianping Xiong
- Department of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China
- Qinghua Yao
- Department of Integrated Chinese and Western Medicine, Cancer Hospital of University of Chinese Academy of Science, Zhejiang Cancer Hospital, Hangzhou 310022, China
- Xin An
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
- Cheng Chen
- Department of Medical Oncology, Jiangsu Cancer Hospital, Nanjing 210009, China
- Yanxia Shi
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
- Jialei Wang
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
- Xiaohua Wang
- Department of Medical Oncology, Jiangsu Cancer Hospital, Nanjing 210009, China
- Zhiqiang Wang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
- Puyuan Xing
- Department of Medical Oncology, National Cancer Center, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
- Sheng Yang
- Department of Medical Oncology, National Cancer Center, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
- Chenfei Zhou
- Department of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
- DOI
- https://doi.org/10.20892/j.issn.2095-3941.2020.0069
- Journal volume & issue
-
Vol. 17,
no. 4
pp. 896 – 909
Abstract
Chemotherapy-induced neutropenia (CIN) is a potentially fatal and common complication in myelosuppressive chemotherapy. The timing and grade of CIN may play prognostic and predictive roles in cancer therapy. CIN is associated with older age, poor functional and nutritional status, the presence of significant comorbidities, the type of cancer, previous chemotherapy cycles, the stage of the disease, specific chemotherapy regimens, and combined therapies. There are many key points and new challenges in the management of CIN in adults including: (1) Genetic risk factors to evaluate the patient’s risk for CIN remain unclear. However, these risk factors urgently need to be identified. (2) Febrile neutropenia (FN) remains one of the most common reasons for oncological emergency. No consensus nomogram for FN risk assessment has been established. (3) Different assessment tools [e.g., Multinational Association for Supportive Care in Cancer (MASCC), the Clinical Index of Stable Febrile Neutropenia (CISNE) score model, and other tools] have been suggested to help stratify the risk of complications in patients with FN. However, current tools have limitations. The CISNE score model is useful to support decision-making, especially for patients with stable FN. (4) There are still some challenges, including the benefits of granulocyte colony stimulating factor treatment and the optimal antibiotic regimen in emergency management of FN. In view of the current reports, our group discusses the key points, new challenges, and management of CIN.
Keywords
- chemotherapy-induced neutropenia (cin)
- febrile neutropenia
- cancer
- risk stratification
- granulocyte-colony stimulating factor (g-csf)
