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Pamela Sue Becker, Elizabeth A. Griffiths, Laura M. Alwan, Kimo Bachiashvili, Anna Brown, Rita Cool, Peter Curtin, Shira Dinner, Ivana Gojo, Ashley Hicks, Avyakta Kallam, Wajih Zaheer Kidwai, Dwight D. Kloth, Eric H. Kraut, Daniel Landsburg, Gary H. Lyman, Ryan Miller, Sudipto Mukherjee, Shiven Patel, Lia E. Perez, Adam Poust, Raajit Rampal, Rachel Rosovsky, Vivek Roy, Hope S. Rugo, Sepideh Shayani, Sumithira Vasu, Martha Wadleigh, Kelly Westbrook, Peter Westervelt, Jennifer Burns, Jennifer Keller, and Lenora A. Pluchino

filgrastim and pegfilgrastim, are primarily used to reduce the incidence of febrile neutropenia (FN) in patients with nonmyeloid malignancies receiving myelosuppressive chemotherapy. FN is a major dose-limiting toxicity of many chemotherapy regimens. Patients

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

the future by more sophisticated personalization of care and more selective administration of interventions to those who stand to benefit most. Use Case: Colony-Stimulating Factors for the Prevention of Febrile Neutropenia Febrile neutropenia

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Jeffrey Crawford, David C. Dale, Nicole M. Kuderer, Eva Culakova, Marek S. Poniewierski, Debra Wolff, and Gary H. Lyman

. Mortality, morbidity, and cost associated with febrile neutropenia in adult cancer patients . Cancer 2006 ; 106 : 2258 – 2266 . 3. Hryniuk W Bush H . The importance of dose intensity in chemotherapy of metastatic breast cancer . J Clin Oncol

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Jeffrey Crawford, James Armitage, Lodovico Balducci, Charles Bennett, Douglas W. Blayney, Spero R. Cataland, David C. Dale, George D. Demetri, Harry P. Erba, James Foran, Alison G. Freifeld, Marti Goemann, Mark L. Heaney, Sally Htoy, Susan Hudock, Dwight D. Kloth, David J. Kuter, Gary H. Lyman, Laura Boehnke Michaud, Sarah C. Miyata, Martin S. Tallman, Saroj Vadhan-Raj, Peter Westervelt, and Michael K. Wong

-Bonte JN de Boo TM Smit HJ . Prevention of chemotherapy-induced febrile neutropenia by prophylactic antibiotics plus or minus granulocyte colony-stimulating factor in small-cell lung cancer: a Dutch randomized phase III study . J Clin Oncol 2005 ; 23

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Elizabeth A. Griffiths, Vivek Roy, Laura Alwan, Kimo Bachiashvili, John Baird, Rita Cool, Shira Dinner, Mark Geyer, John Glaspy, Ivana Gojo, Ashley Hicks, Avyakta Kallam, Wajih Zaheer Kidwai, Dwight D. Kloth, Eric H. Kraut, Daniel Landsburg, Gary H. Lyman, Anjlee Mahajan, Ryan Miller, Victoria Nachar, Seema Patel, Shiven Patel, Lia E. Perez, Adam Poust, Fauzia Riaz, Rachel Rosovsky, Hope S. Rugo, Shayna Simon, Sumithira Vasu, Martha Wadleigh, Kelly Westbrook, Peter Westervelt, Ryan A. Berardi, and Lenora Pluchino

(MGFs), such as granulocyte CSFs (G-CSFs), are primarily used to reduce the incidence of febrile neutropenia (FN) in patients with nonmyeloid malignancies receiving myelosuppressive chemotherapy and to enable safe delivery of planned dose

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Anne K. Hubben, Nathan Pennell, Marc Shapiro, Craig Savage, and James P. Stevenson

Purpose: National guidelines do not include routine pGCSF as primary prophylaxis (PP) for patients receiving chemotherapy associated with a low risk for febrile neutropenia (FN). Inappropriate pGCSF can increase patient morbidity, financial burden

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Neelima Denduluri, Debra A. Patt, Yunfei Wang, Menaka Bhor, Xiaoyan Li, Anne M. Favret, Phuong Khanh Morrow, Richard L. Barron, Lina Asmar, Shanmugapriya Saravanan, Yanli Li, Jacob Garcia, and Gary H. Lyman

the leading dose-limiting toxicities of chemotherapy, and neutropenic complications, especially chemotherapy-induced febrile neutropenia (FN), often lead physicians to reduce or delay planned doses of chemotherapy so as to limit myelotoxicity and allow

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Huntsman Cancer Institute at the University of Utah

Chemotherapy-induced neutropenia can cause complications that result in dose reductions or treatment delays that can, in turn, compromise clinical outcomes. Although the prophylactic use of colony-stimulating factors (CSFs) can reduce the risk, severity, and duration of severe and febrile neutropenia, they are not routinely administered to all patients undergoing myelosuppressive chemotherapy because of the costs. Selective use may, however, enhance their cost-effectiveness. These guidelines discuss the preventative or prophylactic use of recombinant human granulocyte-CSF to reduce the incidence, length, and severity of chemotherapy-related neutropenia and and prevent life-threatening complications.

For the most recent version of the guidelines, please visit NCCN.org

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Jeffrey Crawford

, the NCCN Guidelines Panel initially established the febrile neutropenia threshold for use of myeloid growth factors at 20%; this standard has now been adopted by virtually all other guidelines committees. Moreover, it was the NCCN Panel who stressed