Primary Prophylaxis

This term describes the application of growth factors for the purpose of preventing febrile neutropenia in untreated patients. According to guidelines developed by the American Society of Clinical Oncology (ASCO),10 such prophylaxis is warranted in the setting of treating high-risk patients with chemotherpy regimens associated with at least a 20% likelihood of febrile neutropenia. Most patients in need of intense combination of chemotherapy for newly diagnosed or relapsed leukemia or lymphoma are at high risk for febrile neutropenic complications, either because of disease-related cytopenia, age, poor performancestatus, immune-deficiency, or due to myelosuppres-sion caused by therapy. Most patients suffering from hematologic malignancies should be considered candidates for growth factor support even under the current guidelines, based on conclusions from randomized or well-conducted controlled studies in virtually every disease category and with differing treatment modalities. Debate, however, exists about the use of primary prophylaxis growth factor support in patients with acute myeloid leukemia or advanced myelodysplastic syndrome.

0 0

Post a comment