Who’s at the greatest risk?
Every one of your patients brings a variety of conditions that may put them at an even greater risk of chemotherapy-induced neutropenia (CIN) — and dealing with the consequences.1
Knowing what to look for
may make all the difference
It’s critical to know what can put some patients at an even greater risk for developing CIN. When evaluating your patient, be certain to take into consideration the patient’s:
Place special focus on patient’s chemotherapy type, drug combination, and associated toxicity1
Reduced bone marrow reserves and compromised lung, kidney, and liver functions over time only further increase the risk of chemotherapy-induced complications2
Patients with hematologic malignancies in solid tumors are at a much higher risk of developing CIN and its consequences1
Expert Perspectives in CIN
Dr. Lyman: If you wait until the patient becomes neutropenic, that—after you give chemotherapy, then it’s kind of too late to prevent neutropenia. Prevention means intervening before something occurs. And in this case, when you see a patient, usually the blood counts are in the normal range when you start, but you’re anticipating, you’re predicting what the risk is for that patient over the next few days or week, 10 days that their neutrophils will fall below critical levels and they’ll develop a serious infection…And we know a number of the risk factors that put a patient starting chemotherapy at significant increased risk of febrile neutropenia…however, in the real world, and our models are based on real world populations throughout the United States, we know that often patients that come in for cancer treatment aren’t these pristine, low-risk patients, but they are patients with other comorbid conditions.
Again, they tend to be more elderly, they tend to be patients with other medical conditions that may put them at risk for febrile neutropenia, as well. So, one has to look at the impact of the dose intensity. If you give the full dose, that’s the best chance of beating the cancer. At the same time, it’s the greatest risk of patients developing febrile neutropenia.
Assess your patients’ risk factors before every treatment cycle
- Crawford J, Dale DC, Lyman GH. Chemotherapy-induced neutropenia: risks, consequences, and new directions for its management. Cancer. 2004;15;100(2):228-237.
- Gupta A, Abbasi B, Gupta S. Management of chemotherapy induced neutropenia—an unmet clinical need. Am J Biomed Sci & Res. 2019;4(5):313-318.
- National Comprehensive Cancer Network (NCCN Guidelines®). NCCN Clinical Practice Guidelines in Oncology. Hematopoietic growth factors (Version 2.2020). Published on January 27, 2020. Accessed June 29, 2020. https://www.nccn.org/professionals/physician_gls/pdf/growthfactors.pdf