Introduction Patients receiving the myelosuppressive chemotherapy are vulnerable to febrile neutropenia (FN). Granulocyte colony-stimulating factors(G-CSF) is recommended to use for chemotherapy-induced neutropenia. To determine the incidence of chemotherapy-induced FN and evaluate the outcomes in prophylactic use of pegfilgrastim.
Methods This single-center retrospective study evaluated electronic health records of patients with gynecologic cancer treated between January 2018 and December 2022. The primary outcomes were the incidence of grade 3/4 neutropenia and FN after the first and across all chemotherapy cycles. The secondary outcomes were the incidence of additional laboratory tests and hospitalization.
Results A total of 166 patient records were reviewed. FN was not reported in the prophylactic use of pegfilgrastim and only one case of grade4 neutropenia occurred, except when pegfilgrastim was not used prophylactically in the first cycle. In the group of standard-care chemotherapy, 32patients(23.5%) and 355cases(44%) of grade 3/4 neutropenia were respectively reported in the first cycle and in across all cycles. FN was 5(3.7%) in first cycle and 32(23.5%) in across all cycles(table 1). 7patients were hospitalized in the first cycles and 11 cases were reported in across all cycles. A total 16patients and 74patients experienced additional laboratory tests respectively in the first cycle and across all cycles(table 2).
Conclusion/Implications Prophylactic use of pegfilgrastim in patients who received myelosuppressive chemotherapy may be a preferable option to prevent FN and neutropenia. Although the pegfilgrastim costs expensive, the prophylactic use reduces displeased additional laboratory tests and hospitalization.
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