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CLO19-051: CDK 4/6 Inhibitor-Associated Hematologic Toxicities and Febrile Neutropenia in Patients With Hormone Receptor-Positive HER2-Negative Metastatic Breast Cancer

Sriman Swarup, Anita Sultan, Somedeb Ball, Francis Mogollon-Duffo, Nimesh Adhikari, Yin M. Myat, Myo H. Zaw, Catherine Jones, and Kyaw Z. Thein

: MEDLINE, EMBASE databases, and meeting abstracts from inception through September 2018 were queried. RCTs that mention anemia, thrombocytopenia, leukopenia, neutropenia, and neutropenic fever as adverse effects were incorporated in the analysis. Mantel

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Point: Fluoroquinolone-Based Antibacterial Chemoprophylaxis in Neutropenic Cancer Patients Works for Defined Outcomes in Defined Populations, but Must Be Used Wisely

Eric J. Bow

neutropenia and fever] . Rev Esp Quimioter 2001 ; 14 : 75 – 83 . 3 Hughes WT Armstrong D Bodey GP . 2002 guidelines for the use of antimicrobial agents in neutropenic patients with cancer . Clin Infect Dis 2002 ; 34 : 730 – 751 . 4

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Counterpoint: Routine Anti-Bacterial Prophylaxis Is Not Indicated in Neutropenic Patients With Hematological Malignancies

Michael Kleinberg

. 4 Bodey GP Rodriguez V Chang HY . Fever and infection in leukemic patients . Cancer 1978 ; 41 : 1610 - 1622 . 5 Cruciani M Rampazzo R Malena M . Prophylaxis with fluoroquinolones for bacterial infections in neutropenic patients: A

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BPI19-019: Avoidable Acute Care Use Associated With Nausea and Vomiting Among Patients Receiving Highly Emetogenic Chemotherapy or Oxaliplatin

Eric J Roeland, Thomas W. LeBlanc, Kathryn J. Ruddy, Ryan Nipp, Rebecca Clark-Snow, Rita Wickham, Gary Binder, William L. Bailey, Ravi Potluri, Luke M. Schmerold, Eros Papademetriou, and Rudolph M. Navari

identified rates of IP/ED ≤30 days post-chemotherapy, and OP-35 toxicities (NV, anemia, dehydration, diarrhea, fever, neutropenia, pain, pneumonia, or sepsis) by ICD-9, ICD-10, procedure codes, and CMS criteria. We evaluated cisplatin, anthracycline

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Early Antibiotic Discontinuation or De-escalation in High-Risk Patients With AML With Febrile Neutropenia and Prolonged Neutropenia

William Alegria, Bernard L. Marini, Kevin Sellery Gregg, Dale Lee Bixby, Anthony Perissinotti, and Jerod Nagel

/causative pathogen, and resolution of fever ( Figure 1 ). To proceed with antibiotic de-escalation, patients needed to be afebrile for a minimum of 48 hours and clinically stable as determined by the treating physician. Patients meeting criteria for de

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Leukemic Diffuse Large B-Cell Lymphoma in a Patient With Myeloproliferative Disorder

Vijaya Raj Bhatt, R. Gregory Bociek, Ji Yuan, Kai Fu, Timothy C. Greiner, Bhavana J. Dave, Sandeep K. Rajan, and James O. Armitage

to the University of Nebraska Medical Center (UNMC) for multiple episodes of epistaxis; skin bruises; intermittent fevers; fatigue; anorexia; a few episodes of diarrhea; and dyspnea during the preceding week. At the referring institution, he was found

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Prevention and Treatment of Cancer-Related Infections

Memorial Sloan-Kettering Cancer Center

Infectious diseases are important causes of morbidity and mortality in patients with cancer. In certain instances, the malignancy itself can predispose patients to severe or recurrent infections. Neutropenia has been recognized for many decades as a major risk factor, and effective strategies to anticipate, prevent, and manage infectious complications in patients with cancer experiencing neutropenia have led to improved outcomes. Reflecting the heterogeneity of immunocompromised conditions in patients with cancer and the spectrum of pathogens to which they are susceptible, NCCN expanded the scope of the Fever and Neutropenia Panel in 2007 to create guidelines on Prevention and Treatment of Cancer-Related Infections. These guidelines, newly updated for 2008, characterize major categories of immunologic deficits in persons with cancer and the major pathogens to which they are susceptible.

For the most recent version of the guidelines, please visit

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Management of Chemotherapy-Induced Neutropenia: Measuring Quality, Cost, and Value

Michaela A. Dinan, Bradford R. Hirsch, and Gary H. Lyman

Treatment-associated neutropenia continues to represent the most common dose-limiting toxicity of cancer chemotherapy. It often leads to fever and infection, prompting hospitalization and occasionally resulting in serious morbidity, and even mortality, despite modern broad-spectrum antibiotic treatment and supportive care. Neutropenia and its complications may also lead to chemotherapy dose reductions, treatment delays, or early treatment termination, compromising disease control and the potential for cure. NCCN Clinical Practice Guidelines in Oncology recommend administration of primary prophylaxis with a myeloid growth factor in patients receiving regimens associated with a high risk for febrile neutropenia, and consideration of prophylaxis in patients receiving lower-risk regimens who have other risk factors that might place them at higher risk for febrile neutropenia. Although these agents have been shown to be effective and safe in numerous randomized controlled trials, they are expensive and contribute significantly to increasing health care costs. Regulatory agencies and guideline organizations do not currently address the issue of cost. However, with the relentless increase in health care use and current efforts to reform health care, it has become increasingly important to assess both the cost and the net benefit of interventions related to an episode of care in order to compare the overall value of therapeutic options. This article defines and discusses the intersection of quality, costs, and value in the context of prophylactic myeloid growth factor use in patients with cancer receiving myelosuppressive chemotherapy.

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CRE24-035: Pembrolizumab-Induced Hemophagocytic Lymphohistiocytosis in a Patient With Breast Cancer: A Case Report and Systematic Review of the Literature

Charlotte S. Walmsley, Michael Andersen Jr., Barbara Lam, Deepa Rangachari, Shana Berwick, and Rushad Patell

Background: Hemophagocytic lymphohistiocytosis (HLH) is a severe and often lethal inflammatory syndrome characterized by excessive immune activation leading to fever, cytopenias, and multiorgan involvement. Early identification and treatment of

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HSR24-146: Chemotherapy-Induced Febrile Neutropenia (FN) in the US: Healthcare Resource Utilization (HCRU) and Costs

Edward Li, Marie Yasuda, Jeanine Flanigan, and Chi‐Chang Chen

Background: Neutropenia is a well-established side effect of myelosuppressive chemotherapies that may increase the risk for fever/infection. Updated estimates of the HCRU and cost burden per FN episode are needed to inform treatment strategies