Clinical Outcomes of Secondary Prophylactic Granulocyte Colony-Stimulating Factors in Breast Cancer Patients at a Risk of Neutropenia with Doxorubicin and Cyclophosphamide-Based Chemotherapy

Doxorubicin and cyclophosphamide (AC)-based chemotherapy has been a standard regimen for early-stage breast cancer (ESBC) with an intermediate risk (10–20%) of febrile neutropenia (FN). Secondary prophylaxis of granulocyte colony-stimulating factor (G-CSF) is considered in patients receiving AC-base...

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Autores principales:	Jae Hee Choi, Min Jung Geum, Ji Eun Kang, Nam Gi Park, Yun Kyoung Oh, Sandy Jeong Rhie
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	secondary prophylaxis granulocyte colony-stimulating factor breast cancer neutropenia adjuvant chemotherapy doxorubicin Medicine R Pharmacy and materia medica RS1-441
Acceso en línea:	https://doaj.org/article/918773c20d6940ac9234100a7cc7ce1a
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spelling	oai:doaj.org-article:918773c20d6940ac9234100a7cc7ce1a2021-11-25T18:40:10ZClinical Outcomes of Secondary Prophylactic Granulocyte Colony-Stimulating Factors in Breast Cancer Patients at a Risk of Neutropenia with Doxorubicin and Cyclophosphamide-Based Chemotherapy10.3390/ph141112001424-8247https://doaj.org/article/918773c20d6940ac9234100a7cc7ce1a2021-11-01T00:00:00Zhttps://www.mdpi.com/1424-8247/14/11/1200https://doaj.org/toc/1424-8247Doxorubicin and cyclophosphamide (AC)-based chemotherapy has been a standard regimen for early-stage breast cancer (ESBC) with an intermediate risk (10–20%) of febrile neutropenia (FN). Secondary prophylaxis of granulocyte colony-stimulating factor (G-CSF) is considered in patients receiving AC-based chemotherapy; however, relevant studies are limited. Here, we retrospectively reviewed the electronic medical records of 320 patients who completed adjuvant AC-based chemotherapy from September 2016 to September 2020. Approximately 46.6% of the patients developed severe neutropenic events (SNE) during AC-based chemotherapy. Secondary prophylaxis of G-CSF reduced the risk of recurrent SNE (<i>p</i> < 0.01) and the relative dose intensity (RDI) < 85% (<i>p</i> = 0.03) in patients who had experienced SNE during AC-based chemotherapy. Age ≥ 65 years (<i>p</i> = 0.02) and alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 60 IU/L (<i>p</i> = 0.04) were significant risk factors for RDI < 85%. The incidences of FN, grade 4 neutropenia, unscheduled hospitalization, and interruption to the dosing regimen were reduced in patients administered secondary prophylaxis with G-CSF (before vs. after administration: FN, 19.4% vs. 4.6%; grade 4 neutropenia, 86.1% vs. 14.8%; unscheduled hospitalization, 75.9% vs. 11.1%; interruption to the dosing regimen, 18.5% vs. 8.3%). This study indicated the importance of active intervention of G-CSF use to prevent recurrent SNE and improve clinical outcomes in patients with breast cancer who receive AC-based chemotherapy.Jae Hee ChoiMin Jung GeumJi Eun KangNam Gi ParkYun Kyoung OhSandy Jeong RhieMDPI AGarticlesecondary prophylaxisgranulocyte colony-stimulating factorbreast cancerneutropeniaadjuvant chemotherapydoxorubicinMedicineRPharmacy and materia medicaRS1-441ENPharmaceuticals, Vol 14, Iss 1200, p 1200 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	secondary prophylaxis granulocyte colony-stimulating factor breast cancer neutropenia adjuvant chemotherapy doxorubicin Medicine R Pharmacy and materia medica RS1-441
spellingShingle	secondary prophylaxis granulocyte colony-stimulating factor breast cancer neutropenia adjuvant chemotherapy doxorubicin Medicine R Pharmacy and materia medica RS1-441 Jae Hee Choi Min Jung Geum Ji Eun Kang Nam Gi Park Yun Kyoung Oh Sandy Jeong Rhie Clinical Outcomes of Secondary Prophylactic Granulocyte Colony-Stimulating Factors in Breast Cancer Patients at a Risk of Neutropenia with Doxorubicin and Cyclophosphamide-Based Chemotherapy
description	Doxorubicin and cyclophosphamide (AC)-based chemotherapy has been a standard regimen for early-stage breast cancer (ESBC) with an intermediate risk (10–20%) of febrile neutropenia (FN). Secondary prophylaxis of granulocyte colony-stimulating factor (G-CSF) is considered in patients receiving AC-based chemotherapy; however, relevant studies are limited. Here, we retrospectively reviewed the electronic medical records of 320 patients who completed adjuvant AC-based chemotherapy from September 2016 to September 2020. Approximately 46.6% of the patients developed severe neutropenic events (SNE) during AC-based chemotherapy. Secondary prophylaxis of G-CSF reduced the risk of recurrent SNE (<i>p</i> < 0.01) and the relative dose intensity (RDI) < 85% (<i>p</i> = 0.03) in patients who had experienced SNE during AC-based chemotherapy. Age ≥ 65 years (<i>p</i> = 0.02) and alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 60 IU/L (<i>p</i> = 0.04) were significant risk factors for RDI < 85%. The incidences of FN, grade 4 neutropenia, unscheduled hospitalization, and interruption to the dosing regimen were reduced in patients administered secondary prophylaxis with G-CSF (before vs. after administration: FN, 19.4% vs. 4.6%; grade 4 neutropenia, 86.1% vs. 14.8%; unscheduled hospitalization, 75.9% vs. 11.1%; interruption to the dosing regimen, 18.5% vs. 8.3%). This study indicated the importance of active intervention of G-CSF use to prevent recurrent SNE and improve clinical outcomes in patients with breast cancer who receive AC-based chemotherapy.
format	article
author	Jae Hee Choi Min Jung Geum Ji Eun Kang Nam Gi Park Yun Kyoung Oh Sandy Jeong Rhie
author_facet	Jae Hee Choi Min Jung Geum Ji Eun Kang Nam Gi Park Yun Kyoung Oh Sandy Jeong Rhie
author_sort	Jae Hee Choi
title	Clinical Outcomes of Secondary Prophylactic Granulocyte Colony-Stimulating Factors in Breast Cancer Patients at a Risk of Neutropenia with Doxorubicin and Cyclophosphamide-Based Chemotherapy
title_short	Clinical Outcomes of Secondary Prophylactic Granulocyte Colony-Stimulating Factors in Breast Cancer Patients at a Risk of Neutropenia with Doxorubicin and Cyclophosphamide-Based Chemotherapy
title_full	Clinical Outcomes of Secondary Prophylactic Granulocyte Colony-Stimulating Factors in Breast Cancer Patients at a Risk of Neutropenia with Doxorubicin and Cyclophosphamide-Based Chemotherapy
title_fullStr	Clinical Outcomes of Secondary Prophylactic Granulocyte Colony-Stimulating Factors in Breast Cancer Patients at a Risk of Neutropenia with Doxorubicin and Cyclophosphamide-Based Chemotherapy
title_full_unstemmed	Clinical Outcomes of Secondary Prophylactic Granulocyte Colony-Stimulating Factors in Breast Cancer Patients at a Risk of Neutropenia with Doxorubicin and Cyclophosphamide-Based Chemotherapy
title_sort	clinical outcomes of secondary prophylactic granulocyte colony-stimulating factors in breast cancer patients at a risk of neutropenia with doxorubicin and cyclophosphamide-based chemotherapy
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/918773c20d6940ac9234100a7cc7ce1a
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Clinical Outcomes of Secondary Prophylactic Granulocyte Colony-Stimulating Factors in Breast Cancer Patients at a Risk of Neutropenia with Doxorubicin and Cyclophosphamide-Based Chemotherapy

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