Oncology Medical Affairs, Sandoz Inc, Princeton, NJ, USA.
Value and Access, Novartis Healthcare Pvt. Ltd, Hyderabad, India.
Expert Rev Hematol. 2022 Jul;15(7):619-633. doi: 10.1080/17474086.2022.2093712. Epub 2022 Jul 6.
Febrile neutropenia (FN) is a major dose-limiting toxicity of myelosuppressive chemotherapy, and several patients receiving chemotherapy are at intermediate risk of developing FN. However, the guidelines remain less clear regarding the use of granulocyte colony-stimulating factors (G-CSFs) for this population and insights about real-world prophylaxis patterns and FN outcomes are needed.
This scoping review summarizes the variability in real-world G-CSF prophylaxis treatment patterns, incidence of FN, and associated outcomes among patients receiving chemotherapy at intermediate risk of FN. G-CSF PP use varied across the included studies (N = 23). Overall, there was a trend for reduced FN incidence among patients who received G-CSF PP vs. those who did not. G-CSF PP was also associated with a lower incidence of FN-related dose delays and reductions and fewer hospitalization days. Gaps in the literature of real-world studies exist, particularly around incorporating FN risk factor assessment, patient-reported outcomes, and health economic outcomes.
Further studies are warranted to determine the impact of G-CSF PP use on clinical, quality of life, and economic outcomes in patients with intermediate FN risk, which could optimize care for this subgroup of patients, resulting in better population-based FN-related outcomes.
发热性中性粒细胞减少症（FN）是骨髓抑制性化疗的主要剂量限制毒性，有部分接受化疗的患者存在发生 FN 的中度风险。然而，关于该人群使用粒细胞集落刺激因子（G-CSF）的指南仍不够明确，需要了解有关真实世界预防方案模式和 FN 结局的信息。
本范围综述总结了接受中度 FN 风险化疗的患者中，真实世界 G-CSF 预防治疗模式、FN 发生率和相关结局的可变性。纳入研究中 G-CSF 预防使用情况各不相同（N=23）。总体而言，与未接受 G-CSF 预防的患者相比，接受 G-CSF 预防的患者 FN 发生率呈下降趋势。G-CSF 预防还与 FN 相关的剂量延迟和减少发生率降低以及住院天数减少有关。真实世界研究的文献中存在空白，特别是在纳入 FN 风险因素评估、患者报告结局和卫生经济学结局方面。
需要进一步研究以确定 G-CSF 预防使用对中度 FN 风险患者的临床、生活质量和经济结局的影响，这可以优化该亚组患者的护理，从而改善基于人群的 FN 相关结局。
