Chemotherapy-induced febrile neutropenia: risk factors, prophylaxis, and management with filgrastim in oncological patients

Abstract

Objective: Conduct a literature review of the main risk factors and strategies for prophylaxis and management of chemotherapy-induced febrile neutropenia (FN). Bibliographic review: Chemotherapy-induced FN is a serious complication derived from anticancer treatment with myelosuppressive chemotherapy and is associated with high mortality and morbidity rates. FN risk factors may be related to the patient, the disease, and the chemotherapy regimen. International guidelines recommend using algorithms to stratify patients according to the risk of serious complications resulting from FN. FN prophylaxis and management with granulocyte colony-stimulating factor (G-CSF) reduces the incidence, duration, and mortality rate associated with FN. Filgrastim and pegfilgrastim are the G-CSFs most used in clinical practice, however, they have adverse reactions such as bone and muscle pain, requiring a careful risk-benefit assessment for the patient. G-CSF prophylaxis is mainly recommended for patients undergoing high-risk chemotherapy for FN, or intermediate-risk when the patient has high-risk characteristics. Final considerations: Appropriate prophylaxis and management of FN leads to an increase in the quality of care for cancer patients and a reduction in costs for health systems.