Orbaugh Kristi Kay, Cuellar Sandra, Sheldon Lisa Kennedy
From Community Hospital Oncology Physicians, Indianapolis, Indiana.
University of Illinois Chicago College of Pharmacy, Chicago, Illinois.
J Adv Pract Oncol. 2024 May 22:1-15. doi: 10.6004/jadpro.2024.15.8.5.
Neutropenia and febrile neutropenia (FN) are serious complications of myelosuppressive chemotherapy and present a considerable burden to patients with cancer. Febrile neutropenia is associated with increased risks of infection and hospitalization, a particular concern during the coronavirus disease 2019 (COVID-19) pandemic. Oncology nurses and advanced practice providers (APPs; including nurse practitioners, physician assistants, advanced practice nurses, and pharmacists) play a vital role in the management of patients with cancer and the prevention of infections.
The objectives of this article are to summarize the burden of chemotherapy-related neutropenia and FN in patients with cancer in the US and to evaluate the role of oncology nurses and APPs in preventing and managing FN.
This article provides a narrative review of US studies reporting on the burden of FN, FN during COVID-19, adherence to guidelines for the use of prophylactic granulocyte colony-stimulating factors (G-CSFs), the involvement of oncology nurses in FN prevention, management, and patient quality of life, and inappropriate and/or incomplete G-CSF treatment.
Despite advances in supportive care for patients with cancer receiving myelosuppressive chemotherapy, neutropenia and FN present a considerable burden to patients, particularly during the COVID-19 pandemic. Oncology nurses and APPs play a vital role in the appropriate and timely delivery of supportive care, which can improve patient outcomes and minimize treatment costs.
中性粒细胞减少症和发热性中性粒细胞减少症(FN)是骨髓抑制性化疗的严重并发症,给癌症患者带来了相当大的负担。发热性中性粒细胞减少症与感染和住院风险增加相关,在2019冠状病毒病(COVID-19)大流行期间尤其令人担忧。肿瘤学护士和高级执业提供者(APPs;包括执业护士、医师助理、高级执业护士和药剂师)在癌症患者管理和感染预防中发挥着至关重要的作用。
本文的目的是总结美国癌症患者中化疗相关中性粒细胞减少症和FN的负担,并评估肿瘤学护士和APPs在预防和管理FN中的作用。
本文对美国关于FN负担、COVID-19期间的FN、预防性使用粒细胞集落刺激因子(G-CSFs)指南的依从性、肿瘤学护士在FN预防、管理及患者生活质量方面的参与情况以及G-CSF治疗不当和/或不完整的研究进行了叙述性综述。
尽管接受骨髓抑制性化疗的癌症患者的支持性护理取得了进展,但中性粒细胞减少症和FN给患者带来了相当大的负担,尤其是在COVID-19大流行期间。肿瘤学护士和APPs在适当及时地提供支持性护理方面发挥着至关重要的作用,这可以改善患者预后并使治疗成本最小化。