Neutropenia febril induzida por quimioterapia: fatores de risco, profilaxia e manejo com filgrastim no paciente oncológico
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Oct 24, 2023
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Resumo
Objetivo: Realizar a revisão bibliográfica dos principais fatores de risco e das estratégias para profilaxia e manejo da neutropenia febril (NF) induzida por quimioterapia. Revisão bibliográfica: A NF induzida por quimioterapia é uma complicação grave derivada do tratamento antineoplásico com quimioterápico mielossupressor, estando associada a altas taxas de mortalidade e morbidade. Os fatores de risco para NF podem estar relacionados ao paciente, a doença e ao regime de quimioterapia. Diretrizes internacionais recomendam a utilização de algoritmos para estratificar os pacientes quanto ao risco de complicações graves decorrentes da NF. A profilaxia e o manejo da NF com fator estimulador de colônia de granulócitos (G-CSF), reduz a incidência, duração, e taxa de mortalidade associada a NF. Filgrastim e pegfilgrastim são os G-CSF mais utilizados na prática clínica, porém, apresentam reações adversas como dor óssea e muscular, sendo necessária uma avaliação cuidadosa do risco-benefício para o paciente. A profilaxia com G-CSF é recomendada principalmente para pacientes submetidos a quimioterápicos de alto risco para NF, ou de risco intermediário quando o paciente apresenta características de alto-risco. Considerações finais: A adequada profilaxia e manejo da NF acarreta aumento da qualidade da assistência ao paciente oncológico e redução dos custos para os sistemas de saúde.
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Como Citar
Serra-CamposA. O., MartinsC. S. M., BadinR. C., & ManaçasL. R. A. (2023). Neutropenia febril induzida por quimioterapia: fatores de risco, profilaxia e manejo com filgrastim no paciente oncológico. Revista Eletrônica Acervo Saúde, 23(10), e14375. https://doi.org/10.25248/reas.e14375.2023
Seção
Revisão Bibliográfica
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Referências
1. AAPRO MS, et al. 2010 update of EORTC guidelines for the use of granulocyte-colony stimulating factor to reduce the incidence of chemotherapy-induced febrile neutropenia in adult patients with lymphoproliferative disorders and solid tumours. European journal of cancer, 2011; 47(1): 8-32.
2. BA Y, et al. Current management of chemotherapy-induced neutropenia in adults: key points and new challenges: Committee of Neoplastic Supportive-Care (CONS), China Anti-Cancer Association Committee of Clinical Chemotherapy, China Anti-Cancer Association. Cancer Biology & Medicine, 2020; 17(4): 896-909.
3. BACHU RD, et al. Oncology biosimilars: New developments and future directions. Cancer Reports, 2022; 5(11): e1720.
4. BENNETT CL, et al. Colony-stimulating factors for febrile neutropenia during cancer therapy. New England Jounal of Medicine, 2013; 368(12): 1131-1139.
5. BLAYNEY DW, et al. Efficacy of Plinabulin vs Pegfilgrastim for Prevention of Docetaxel-Induced Neutropenia in Patients With Solid Tumors: A Randomized Clinical Trial. JAMA Network Open, 2022; 5(1): e2145446.
6. COBB PW, et al. A comparison of eflapegrastim to pegfilgrastim in the management of chemotherapy-induced neutropenia in patients with early-stage breast cancer undergoing cytotoxic chemotherapy (RECOVER): A Phase 3 study. Cancer Medicine, 2020; 9(17): 6234-6243.
7. CRAWFORD J, et al. Myeloid Growth Factors, Version 2.2017, NCCN Clinical Practice Guidelines in Oncology. Journal of National Comprehensive Cancer Network, 2017; 15(12): 1520-1541.
8. DAVIS K e WILSON S. Febrile neutropenia in paediatric oncology. Ped Child Health, 2020; 30(3): 93-97.
9. DARMON M, et al. Impact of neutropenia duration on short-term mortality in neutropenic critically ill cancer patients. Intensive care medicine, 2002; 28(12): 1775-1780.
10. DE NAUROIS J, et al. Management of febrile neutropenia: ESMO Clinical Practice Guidelines. Annals of oncology, 2010; 21(SUPPL. 5): 252-256.
11. DULISSE B, et al. A retrospective study of the clinical and economic burden during hospitalizations among cancer patients with febrile neutropenia. Journal of medical economics. 2013; 16(6): 720-735.
12. EDELSBERG J, et al. Prophylaxis of febrile neutropenia with colony-stimulating factors: the first 25 years. Current medical research and opinion, 2019; 36(3): 483-495.
13. ESCRIHUELA-VIDAL F, et al. Update on the management of febrile neutropenia in hematologic patients. Revista Española de Quimioterapia, 2019; 32(Suppl 2): 55-58.
14. FERREIRA JN, et al. Managing febrile neutropenia in adult cancer patients: an integrative review of the literature. Revista Brasileira de Enfermagem, 2017; 70(6): 1301-1308.
15. FLOWERS CR, et al. Antimicrobial prophylaxis and outpatient management of fever and neutropenia in adults treated for malignancy: American Society of Clinical Oncology clinical practice guideline. Journal of clinical oncology, 2013; 31(6): 794-810.
16. GONZÁLEZ-BARCA E, et al. Prognostic factors influencing mortality in cancer patients with neutropenia and bacteremia. European journal of clinical microbiology & infectious diseases, 1999; 18(8): 539-544.
17. KLASTERSKY J, et al. The Multinational Association for Supportive Care in Cancer risk index: A multinational scoring system for identifying low-risk febrile neutropenic cancer patients. ournal of clinical oncology, 2000; 18(16): 3038-3051.
18. KAUSHANSKY K. Lineage-specific hematopoietic growth factors. The New England journal of medicine, 2006; 354(19): 2034-2045.
19. KLASTERSKY J e PAESMANS M. The Multinational Association for Supportive Care in Cancer (MASCC) risk index score: 10 years of use for identifying low-risk febrile neutropenic cancer patients. Support Care Cancer, 2013; 21(5): 1487-1495.
20. KLASTERSKY J, et al. Management of febrile neutropaenia: ESMO Clinical Practice Guidelines. Annals of oncology, 2016; 27(suppl 5): v111-v118.
21. KUDERER NM, et al. Mortality, morbidity, and cost associated with febrile neutropenia in adult cancer patients. Cancer, 2006; 106(10): 2258-2266.
22. LEE MW, et al. Efficacy of cisplatin combined with topotecan in patients with advanced or recurrent ovarian cancer as second- or higher-line palliative chemotherapy. Medicine, 2020; 99(17): e19931.
23. LIMBERGER LM e BONFIM FILHO JA. Febrile neutropenia in cancer patients: a literature review. Research, Society and Development, 2023; 12(2): e27812240347.
24. LISBOA LCC, et al. O uso do Filgrastim como profilaxia para a neutropenia febril induzida pela quimioterapia: uma revisão de literatura. Revista Eletrônica Acervo Médico, 2022; 19: e10944.
25. LYMAN GH, et al. Risk factors for febrile neutropenia among patients with cancer receiving chemotherapy: A systematic review. Critical reviews in oncology/hematology, 2014; 90(3): 190-199.
26. MALIK I, et al. Clinical characteristics and therapeutic outcome of patients with febrile neutropenia who present in shock: need for better strategies. The Journal of infection, 2001; 42(2): 120-125.
27. MAZZARO RT, et al. Management of chemotherapy-induced febrile neutropenia and use of granulocyte colony-stimulating factor in patients with soft tissue or bone sarcoma. J of onco pharmacy practice, 2022.
28. ONO Y, et al. Can MASCC and CISNE scores predict delays of lung cancer chemotherapy after febrile neutropenia? Thoracic Cancer, 2022; 13(24): 3504-3509.
29. PAESMANS M, et al. Predicting febrile neutropenic patients at low risk using the MASCC score: does bacteremia matter?. Supportive care in cancer, 2011; 19(7): 1001-1008.
30. PATHAK R, et al. Mortality, length of stay, and health care costs of febrile neutropenia-related hospitalizations among patients with breast cancer in the United States. Sup canc, 2015; 23(3): 615-617.
31. RABAGLIATI BR, et al. Etiología de episodios de neutropenia febril en pacientes adultos con cáncer hematológico y de órganos sólidos en el Hospital Clínico Universidad Católica, Santiago-Chile. Revista chilena de infectologia, 2009; 26(2): 106-113.
32. SALAKO O, et al. Chemotherapy induced neutropenia and febrile neutropenia among breast cancer patients in a tertiary hospital in Nigeria. E cancer medical science, 2021; 15: 1188.
33. SMITH TJ, et al. Recommendations for the use of WBC growth factors: American society of clinical oncology clinical practice guideline update. Journal of Clinical Oncology, 2015; 33(28): 3199-3212.
34. TALCOTT JA, et al. The Medical Course of Cancer Patients With Fever and Neutropenia: Clinical Identification of a Low-Risk Subgroup at Presentation. Ar of internal medicine, 1988; 148(12): 2561-2568.
35. TAPLITZ RA, et al. Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy: American Society of Clinical Oncology and Infectious Diseases Society of America Clinical Practice Guideline Update. Journal of clinical oncology, 2018; 36(14): 1443-1453.
36. UYS A, et al. Febrile neutropenia: a prospective study to validate the Multinational Association of Supportive Care of Cancer (MASCC) risk-index score. Supportive care in cancer, 2004; 12(8): 555-560.
37. ZIMMER AJ, Freifeld AG. Optimal Management of Neutropenic Fever in Patients With Cancer. Journal of oncology practice. 2019; 15(1): 19-24.
38. WHITE L e YBARRA M. Neutropenic Fever. Emergency medicine clinics of North America, 2014; 32(3): 549-561.
2. BA Y, et al. Current management of chemotherapy-induced neutropenia in adults: key points and new challenges: Committee of Neoplastic Supportive-Care (CONS), China Anti-Cancer Association Committee of Clinical Chemotherapy, China Anti-Cancer Association. Cancer Biology & Medicine, 2020; 17(4): 896-909.
3. BACHU RD, et al. Oncology biosimilars: New developments and future directions. Cancer Reports, 2022; 5(11): e1720.
4. BENNETT CL, et al. Colony-stimulating factors for febrile neutropenia during cancer therapy. New England Jounal of Medicine, 2013; 368(12): 1131-1139.
5. BLAYNEY DW, et al. Efficacy of Plinabulin vs Pegfilgrastim for Prevention of Docetaxel-Induced Neutropenia in Patients With Solid Tumors: A Randomized Clinical Trial. JAMA Network Open, 2022; 5(1): e2145446.
6. COBB PW, et al. A comparison of eflapegrastim to pegfilgrastim in the management of chemotherapy-induced neutropenia in patients with early-stage breast cancer undergoing cytotoxic chemotherapy (RECOVER): A Phase 3 study. Cancer Medicine, 2020; 9(17): 6234-6243.
7. CRAWFORD J, et al. Myeloid Growth Factors, Version 2.2017, NCCN Clinical Practice Guidelines in Oncology. Journal of National Comprehensive Cancer Network, 2017; 15(12): 1520-1541.
8. DAVIS K e WILSON S. Febrile neutropenia in paediatric oncology. Ped Child Health, 2020; 30(3): 93-97.
9. DARMON M, et al. Impact of neutropenia duration on short-term mortality in neutropenic critically ill cancer patients. Intensive care medicine, 2002; 28(12): 1775-1780.
10. DE NAUROIS J, et al. Management of febrile neutropenia: ESMO Clinical Practice Guidelines. Annals of oncology, 2010; 21(SUPPL. 5): 252-256.
11. DULISSE B, et al. A retrospective study of the clinical and economic burden during hospitalizations among cancer patients with febrile neutropenia. Journal of medical economics. 2013; 16(6): 720-735.
12. EDELSBERG J, et al. Prophylaxis of febrile neutropenia with colony-stimulating factors: the first 25 years. Current medical research and opinion, 2019; 36(3): 483-495.
13. ESCRIHUELA-VIDAL F, et al. Update on the management of febrile neutropenia in hematologic patients. Revista Española de Quimioterapia, 2019; 32(Suppl 2): 55-58.
14. FERREIRA JN, et al. Managing febrile neutropenia in adult cancer patients: an integrative review of the literature. Revista Brasileira de Enfermagem, 2017; 70(6): 1301-1308.
15. FLOWERS CR, et al. Antimicrobial prophylaxis and outpatient management of fever and neutropenia in adults treated for malignancy: American Society of Clinical Oncology clinical practice guideline. Journal of clinical oncology, 2013; 31(6): 794-810.
16. GONZÁLEZ-BARCA E, et al. Prognostic factors influencing mortality in cancer patients with neutropenia and bacteremia. European journal of clinical microbiology & infectious diseases, 1999; 18(8): 539-544.
17. KLASTERSKY J, et al. The Multinational Association for Supportive Care in Cancer risk index: A multinational scoring system for identifying low-risk febrile neutropenic cancer patients. ournal of clinical oncology, 2000; 18(16): 3038-3051.
18. KAUSHANSKY K. Lineage-specific hematopoietic growth factors. The New England journal of medicine, 2006; 354(19): 2034-2045.
19. KLASTERSKY J e PAESMANS M. The Multinational Association for Supportive Care in Cancer (MASCC) risk index score: 10 years of use for identifying low-risk febrile neutropenic cancer patients. Support Care Cancer, 2013; 21(5): 1487-1495.
20. KLASTERSKY J, et al. Management of febrile neutropaenia: ESMO Clinical Practice Guidelines. Annals of oncology, 2016; 27(suppl 5): v111-v118.
21. KUDERER NM, et al. Mortality, morbidity, and cost associated with febrile neutropenia in adult cancer patients. Cancer, 2006; 106(10): 2258-2266.
22. LEE MW, et al. Efficacy of cisplatin combined with topotecan in patients with advanced or recurrent ovarian cancer as second- or higher-line palliative chemotherapy. Medicine, 2020; 99(17): e19931.
23. LIMBERGER LM e BONFIM FILHO JA. Febrile neutropenia in cancer patients: a literature review. Research, Society and Development, 2023; 12(2): e27812240347.
24. LISBOA LCC, et al. O uso do Filgrastim como profilaxia para a neutropenia febril induzida pela quimioterapia: uma revisão de literatura. Revista Eletrônica Acervo Médico, 2022; 19: e10944.
25. LYMAN GH, et al. Risk factors for febrile neutropenia among patients with cancer receiving chemotherapy: A systematic review. Critical reviews in oncology/hematology, 2014; 90(3): 190-199.
26. MALIK I, et al. Clinical characteristics and therapeutic outcome of patients with febrile neutropenia who present in shock: need for better strategies. The Journal of infection, 2001; 42(2): 120-125.
27. MAZZARO RT, et al. Management of chemotherapy-induced febrile neutropenia and use of granulocyte colony-stimulating factor in patients with soft tissue or bone sarcoma. J of onco pharmacy practice, 2022.
28. ONO Y, et al. Can MASCC and CISNE scores predict delays of lung cancer chemotherapy after febrile neutropenia? Thoracic Cancer, 2022; 13(24): 3504-3509.
29. PAESMANS M, et al. Predicting febrile neutropenic patients at low risk using the MASCC score: does bacteremia matter?. Supportive care in cancer, 2011; 19(7): 1001-1008.
30. PATHAK R, et al. Mortality, length of stay, and health care costs of febrile neutropenia-related hospitalizations among patients with breast cancer in the United States. Sup canc, 2015; 23(3): 615-617.
31. RABAGLIATI BR, et al. Etiología de episodios de neutropenia febril en pacientes adultos con cáncer hematológico y de órganos sólidos en el Hospital Clínico Universidad Católica, Santiago-Chile. Revista chilena de infectologia, 2009; 26(2): 106-113.
32. SALAKO O, et al. Chemotherapy induced neutropenia and febrile neutropenia among breast cancer patients in a tertiary hospital in Nigeria. E cancer medical science, 2021; 15: 1188.
33. SMITH TJ, et al. Recommendations for the use of WBC growth factors: American society of clinical oncology clinical practice guideline update. Journal of Clinical Oncology, 2015; 33(28): 3199-3212.
34. TALCOTT JA, et al. The Medical Course of Cancer Patients With Fever and Neutropenia: Clinical Identification of a Low-Risk Subgroup at Presentation. Ar of internal medicine, 1988; 148(12): 2561-2568.
35. TAPLITZ RA, et al. Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy: American Society of Clinical Oncology and Infectious Diseases Society of America Clinical Practice Guideline Update. Journal of clinical oncology, 2018; 36(14): 1443-1453.
36. UYS A, et al. Febrile neutropenia: a prospective study to validate the Multinational Association of Supportive Care of Cancer (MASCC) risk-index score. Supportive care in cancer, 2004; 12(8): 555-560.
37. ZIMMER AJ, Freifeld AG. Optimal Management of Neutropenic Fever in Patients With Cancer. Journal of oncology practice. 2019; 15(1): 19-24.
38. WHITE L e YBARRA M. Neutropenic Fever. Emergency medicine clinics of North America, 2014; 32(3): 549-561.