Delivering Full Planned Dose on Time (PDOT) Chemotherapy (CT) While Lowering the Incidence of Febrile Neutropenia (FN) Hospitalizations in High Risk Breast Cancer Patients (BCP)

2.50
Hdl Handle:
http://hdl.handle.net/10755/165601
Category:
Abstract
Type:
Presentation
Title:
Delivering Full Planned Dose on Time (PDOT) Chemotherapy (CT) While Lowering the Incidence of Febrile Neutropenia (FN) Hospitalizations in High Risk Breast Cancer Patients (BCP)
Author(s):
Hinton, Jerry
Author Details:
Jerry Hinton, Mid-Ohio Oncology Hematology Inc., Columbus, Ohio, USA
Abstract:
Recent studies suggest that about 20% of early-stage BCP receive £85% of intended dose intensity (DI) when treated with CT. Neutropenia was found to be the primary reason for delays and reductions. Bonadonna et al. have suggested that women who receive less than 85% total planned CT dose have a poorer prognosis. Budman et al. have shown that BCP who received less than standard or moderate dose therapy have inferior outcomes. Dr. Jeffrey Silber published a risk model (JCO, 1998) that showed first cycle nadir absolute neutrophil counts (ANC) can predict the probability of subsequent neutropenic events. To prospectively evaluate the efficacy of such a risk model in delivering PDOT and reducing FN hospitalizations, stage I-III BCP receiving adjuvant AC, CMF, or CAF were enrolled in a non-randomized study. Patients with a first cycle nadir ANC £500mm3 were assigned to the high risk (HR) group; patients with an ANC >500/mm3 were assigned to the low risk group. HR patients received G-CSF (Filgrastim) for all subsequent cycles starting 24 hours after CT and continuing to a post nadir ANC³10,000/mm3. LR patients did not receive G-CSF unless an FN episode or a delay due to neutropenia occurred. The relative dose intensity (RDI) for the study subjects was compared to the RDI for a large historical control group consisting of BCP who received the same CT regimens. Overall 20.1% of historical control patients versus 4.7% of all study subjects received £85% PDOT while 7.1% versus 2.7% respectively were hospitalized for FN. This trial of 528 patients demonstrates the feasibility of identifying a subgroup of BCP at high risk for neutropenia who would most benefit from targeted use of Filgrastim support to deliver PDOT while reducing these HR patients and assure they achieve greater than 85% planned DI. They also play a crucial educational role in helping patients understand the rationale for maintaining planned dose intensity in early stage breast cancer treatment.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2002
Conference Name:
27th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
Washington, D.C., USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleDelivering Full Planned Dose on Time (PDOT) Chemotherapy (CT) While Lowering the Incidence of Febrile Neutropenia (FN) Hospitalizations in High Risk Breast Cancer Patients (BCP)en_GB
dc.contributor.authorHinton, Jerryen_US
dc.author.detailsJerry Hinton, Mid-Ohio Oncology Hematology Inc., Columbus, Ohio, USAen_US
dc.identifier.urihttp://hdl.handle.net/10755/165601-
dc.description.abstractRecent studies suggest that about 20% of early-stage BCP receive £85% of intended dose intensity (DI) when treated with CT. Neutropenia was found to be the primary reason for delays and reductions. Bonadonna et al. have suggested that women who receive less than 85% total planned CT dose have a poorer prognosis. Budman et al. have shown that BCP who received less than standard or moderate dose therapy have inferior outcomes. Dr. Jeffrey Silber published a risk model (JCO, 1998) that showed first cycle nadir absolute neutrophil counts (ANC) can predict the probability of subsequent neutropenic events. To prospectively evaluate the efficacy of such a risk model in delivering PDOT and reducing FN hospitalizations, stage I-III BCP receiving adjuvant AC, CMF, or CAF were enrolled in a non-randomized study. Patients with a first cycle nadir ANC £500mm3 were assigned to the high risk (HR) group; patients with an ANC >500/mm3 were assigned to the low risk group. HR patients received G-CSF (Filgrastim) for all subsequent cycles starting 24 hours after CT and continuing to a post nadir ANC³10,000/mm3. LR patients did not receive G-CSF unless an FN episode or a delay due to neutropenia occurred. The relative dose intensity (RDI) for the study subjects was compared to the RDI for a large historical control group consisting of BCP who received the same CT regimens. Overall 20.1% of historical control patients versus 4.7% of all study subjects received £85% PDOT while 7.1% versus 2.7% respectively were hospitalized for FN. This trial of 528 patients demonstrates the feasibility of identifying a subgroup of BCP at high risk for neutropenia who would most benefit from targeted use of Filgrastim support to deliver PDOT while reducing these HR patients and assure they achieve greater than 85% planned DI. They also play a crucial educational role in helping patients understand the rationale for maintaining planned dose intensity in early stage breast cancer treatment.en_GB
dc.date.available2011-10-27T12:21:38Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:21:38Z-
dc.conference.date2002en_US
dc.conference.name27th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationWashington, D.C., USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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