Chemotherapy-induced febrile neutropenia and use of granulocyte colony-stimulating factors in older cancer patients

B. Bruun, A. Kargo, Trine Lembrecht Jørgensen, J. Herrstedt

Research output: Contribution to journalConference abstract in journalResearchpeer-review


Introduction: Febrile neutropenia (FN) is a serious adverse effect of myelosup-pressive chemotherapy and elderly patients are at increased risk. FN can lead to dose reduction, associated with a poor prognosis. Granulocyte colony-stimulating factors (G-CSF) reduce the incidence of FN and increase the chance of chemotherapy dose intensity and dose density adherence. Objectives: To evaluate the incidence of FN and adherence to the guidelines regarding use of G-CSF in elderly cancer patients. Methods: Retrospective study of patients > 70 years receiving their first course of chemotherapy at the Department of Oncology, Odense University Hospital, Denmark. Patients had a diagnosis of colorectal (n=206), prostate (n=100), or ovarian cancer (n=99). They received at least one cycle of chemotherapy and data were collected from the medical charts for all the patients. The risk of developing FN with chemotherapy regimens used was estimated as described by the EORTC guidelines. Results: In all, 367 patients were included. Twelve (3.3 %) developed FN after their initial chemotherapy. Seven (1.9 %) and eight (2.2 %) patients respectively, received primary and secondary prophylactic G-CSF. Sixty-nine (18.8 %) had their first dose reduced. According to guidelines, 113 (30.8 %) should have received primary prophylactic G-CSF. Conclusions: In our institution, use of primary prophylactic G-CSF was inconsistent and often refrained from. FN was observed in only 12 of 367 patients, but the initial dose of chemotherapy was reduced in as many as 19 % of patients. Prospective studies are highly warranted to explore optimal use of G-CSF in order to avoid systematic dose reduction due to age.
Original languageEnglish
Article number07-03-P
JournalSupportive Care in Cancer
Issue numberSUPPL. 1
Pages (from-to)S91
Number of pages1
Publication statusPublished - 2015
EventMASCC/ISOO International Symposium - Bella Center, Copenhagen, Denmark
Duration: 25. Jun 201527. Jun 2015


SeminarMASCC/ISOO International Symposium
LocationBella Center

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