World Journal of Surgical Medical and Radiation Oncology Volume No 8

Research Open Access

Prophylactic use of Granulocyte Colony Stimulating Factor (G-CSF) in Febrile Neutropenia- A Single Institutional Study

Shaqul Qamar Wani, Talib Khan and Mohammad Maqbool Lone
World Journal of Surgical Medical and Radiation Oncology 2019, 8:1

Abstract

Background

Breast cancer is the most common cancer among women in India and most of the patients need chemotherapy (CT) as a part of multimodal management. CT induced febrile Neutropenia (FN) causes unnecessary treatment interruptions which may have negative impact on disease outcome, besides unwanted hospitalization, treatment costs and high mortality rates.

Methodology

Sixty-six female breast cancer patients with early and locally advanced disease were started on various chemotherapeutic (CT)regimens after excluding 11 patients .The various regimens used were having risk of FN hence, were started on prophylactic granulocyte colony stimulating factors (G-CSF) (Filgrastim) 5 microgram/ KgBW subcutaneously (SC) after 24hours of completion of CT consecutively for five days. The main purpose of the study was to prevent neutropenia (febrile or afebrile) and its associated morbidity. Also the intention of the study was to complete CT on scheduled time, without unnecessary treatment delays and dose reductions which could have strong impact on disease outcome, patient’s survival, costs and hospitalizations as well as mortality associated with it.

Results

The mean age of the patients was 48.77± 9.69 years. Four of 27 (14.81%) patients on TAC protocol developed FN out of which three had grade 3, and only one had grade 4 FN and required hospitalization. Three of 39 (7.69%) patients on other CT protocols, developed FN and was of grade 3, making a total of seven (10.6%) out of 66 patients. Conclusion: This study concluded that although 10.6% patients showed FN despite of G-CSF prophylaxis, the grade of FN was less severe (grade 3) in majority of patients and were managed and recovered well from the neutropenia on outpatient basis. Hence, we recommend the prophylactic use of G-CSF as it decreases the incidence and severity of life threatening neutropenia.
 

Keywords

febrile neutropenia, myelosuppression, breast cancer, chemotherapy, granulocyte colony stimulating factor




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