Current management of chemotherapy-induced neutropenia in adults: key points and new challenges

被引：51

作者：

Ba, Yi ^{[1
]}

Shi, Yuankai ^{[2
]}

Jiang, Wenqi ^{[3
]}

Feng, Jifeng ^{[4
]}

Chengs, Ying ^{[5
]}

Xiao, Li ^{[6
]}

Zhang, Qingyuan ^{[7
]}

Qiu, Wensheng ^{[8
]}

Xu, Binghe ^{[2
]}

Xu, Ruihua ^{[3
]}

Shen, Bo ^{[4
]}

Luo, Zhiguo ^{[9
]}

Xie, Xiaodong ^{[10
]}

Chang, Jianhua ^{[9
]}

Wang, Mengzhao ^{[11
]}

Li, Yufu ^{[12
]}

Shuang, Yuerong ^{[13
]}

Niu, Zuoxing ^{[14
]}

Liu, Bo ^{[14
]}

Zhang, Jun ^{[15
]}

Zhang, Li ^{[3
]}

Yao, Herui ^{[16
]}

Xie, Conghua ^{[17
]}

Huang, Huiqiang ^{[2
]}

Liao, Wangjun ^{[18
]}

Chen, Gongyan ^{[7
]}

Zhang, Xiaotian ^{[19
]}

An, Hanxiang ^{[20
]}

Deng, Yanhong ^{[21
]}

Gong, Ping ^{[22
]}

Xiong, Jianping ^{[23
]}

Yao, Qinghua ^{[24
]}

Ana, Xin ^{[3
]}

Chen, Cheng ^{[4
]}

Shia, Yanxia ^{[3
]}

Wang, Jialei ^{[9
]}

Wang, Xiaohua ^{[4
]}

Wang, Zhiqiang ^{[3
]}

Xing, Puyuan ^{[2
]}

Yang, Sheng ^{[2
]}

Zhou, Chenfei ^{[15
]}

机构：

[1] Tianjin Med Univ Canc Inst & Hosp, Natl Clin Res Ctr Canc, Tianjins Clin Res Ctr Canc, Dept Gastrointestinal Med Oncol,Key Lab Canc Prev, Tianjin 300060, Peoples R China

[2] Chinese Acad Med Sci & Peking Union Med Coll, Natl Canc Ctr, Canc Hosp, Dept Med Oncol, Beijing 100021, Peoples R China

[3] Sun Yat Sen Univ, Dept Med Oncol, Canc Ctr, Guangzhou 510060, Peoples R China

[4] Jiangsu Canc Hosp, Dept Med Oncol, Nanjing 210009, Peoples R China

[5] Jilin Prov Canc Hosp, Dept Oncol, Changchun 130012, Peoples R China

[6] Xiamen Univ, Dept Oncol, Zhongshan Hosp, Xiamen 361004, Peoples R China

[7] Harbin Med Univ, Dept Oncol, Canc Hosp, Harbin 150081, Peoples R China

[8] Qingdao Univ, Affiliated Hosp, Dept Oncol, Qingdao 266003, Peoples R China

[9] Fudan Univ, Dept Med Oncol, Shanghai Canc Ctr, Shanghai 200032, Peoples R China

[10] Gen Hosp Shenyang Mil Reg, Dept Oncol, Shenyang 110016, Peoples R China

[11] Peking Union Med Coll Hosp, Dept Pulm & Crit Care Med, Beijing 100730, Peoples R China

[12] Zhengzhou Univ, Henan Canc Hosp, Dept Hematol, Affiliated Canc Hosp, Zhengzhou 450008, Peoples R China

[13] Jiangxi Canc Hosp, Lymphoma & Myeloma Dept, Nanchang 330029, Jiangxi, Peoples R China

[14] Shandong Acad Med Sci, Shandong Canc Hosp, Dept Med Oncol, Jinan 250117, Peoples R China

[15] Shanghai Jiao Tong Univ, Ruijin Hosp, Dept Oncol, Sch Med, Shanghai 200025, Peoples R China

[16] Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Guangzhou 510120, Peoples R China

[17] Wuhan Univ, Zhongnan Hosp, Dept Radiat & Med Oncol, Wuhan 430070, Peoples R China

[18] Southern Med Univ, Nanfang Hosp, Dept Oncol, Guangzhou 510515, Peoples R China

[19] Peking Univ, Dept Gastrointestinal Oncol, Canc Hosp & Inst, Beijing 100142, Peoples R China

[20] Xiamen Univ, Xiangan Hosp, Dept Med Oncol, Xiamen 361101, Peoples R China

[21] Sun Yat Sen Univ, Affiliated Hosp 6, Dept Med Oncol, Guangzhou 510655, Peoples R China

[22] Shihezi Univ, Affiliated Hosp 1, Sch Med, Dept Oncol, Shihezi 832000, Peoples R China

[23] Nanchang Univ, Affiliated Hosp 1, Dept Oncol, Nanchang 330006, Jiangxi, Peoples R China

[24] Univ Chinese Acad Sci, Zhejiang Canc Hosp, Dept Integrated Chinese & Western Med, Canc Hosp, Hangzhou 310022, Peoples R China

来源：

CANCER BIOLOGY & MEDICINE | 2020年 / 17卷 / 04期

关键词：

Chemotherapy-induced neutropenia (CIN); febrile neutropenia; cancer; risk stratification; granulocyte-colony stimulating factor (G-CSF); COLONY-STIMULATING FACTORS; INDUCED FEBRILE NEUTROPENIA; CELL LUNG-CANCER; MASCC RISK INDEX; ACTING G-CSF; PROGNOSTIC-FACTOR; OUTPATIENT MANAGEMENT; CLINICAL-PRACTICE; PREDICTION; PROPHYLAXIS;

D O I：

10.20892/j.issn.2095-3941.2020.0069

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Chemotherapy-induced neutropenia (CIN) is a potentially fatal and common complication in myelosuppressive chemotherapy. The timing and grade of CIN may play prognostic and predictive roles in cancer therapy. CIN is associated with older age, poor functional and nutritional status, the presence of significant comorbidities, the type of cancer, previous chemotherapy cycles, the stage of the disease, specific chemotherapy regimens, and combined therapies. There are many key points and new challenges in the management of CIN in adults including: (1) Genetic risk factors to evaluate the patient's risk for CIN remain unclear. However, these risk factors urgently need to be identified. (2) Febrile neutropenia (FN) remains one of the most common reasons for oncological emergency. No consensus nomogram for FN risk assessment has been established. (3) Different assessment tools [e.g., Multinational Association for Supportive Care in Cancer (MASCC), the Clinical Index of Stable Febrile Neutropenia (CISNE) score model, and other tools] have been suggested to help stratify the risk of complications in patients with FN. However, current tools have limitations. The CISNE score model is useful to support decision-making, especially for patients with stable FN. (4) There are still some challenges, including the benefits of granulocyte colony stimulating factor treatment and the optimal antibiotic regimen in emergency management of FN. In view of the current reports, our group discusses the key points, new challenges, and management of CIN.

引用

页码：896 / 909

页数：14

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