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KMID : 0869620080250030006
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Journal of Korean Society of Hospital Pharmacists
2008 Volume.25 No. 3 p.6 ~ p.0
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Drug Use Status and Optimal Administration Time of Colony-Stimulating Factor(CSF) for Solid Cancer Patients
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Lee Sun-Young
Choi Soo-An
Namgung Hyung-Wook
Lee Eun-Sook
Lee Byung-Koo
Shin Wan-Gyoon
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Abstract
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The neutropenia is one of the most critical adverse effects of chemotherapy.
Prophylaxis of neutropenia is very important because neutropenic patients are susceptible to infection, which is one of the leading cause of death. American Society of Clinical Oncology recommends that CSF as prophylactic should be given 24 to 72 hours after the administration of myelotoxic chemotherapy. The purpose of this study is to investigate the CSF administration timing and clinical effectiveness of CSF on neutropenia prophylaxis according to initiating time. Data were collected retrospectively from Electronic Medical Record of solid cancer patients who have been administrated prophylactic CSF after chemotherapy in Seoul National University Bundang Hospital from January 1st to June 30th in 2007. Patients were divided into two different groups, based on timing of CSF initiation after chemotherapy. One group being administrated CSF within 24 hours and another group after 24 hours. Related parameters such as age, diagnosis, chemo-regimen and chemotherapy history as well as ANC, development of fever, infection, antibiotic use, and delay to next chemotherapy were investigated. 79 cases were enrolled, and 55 cases were within 24 hours and 24 cases were after 24 hours. Hematology-oncology patients were administrated CSF after 24 hours in most cases, Obstetrics and gynecology(OBGY) patients were administrated it in the same day when chemotherapy finished then there were more cases that CSF was given within 24 hours in OBGY. From two groups we found 8 cases (14.5%), 7 cases (29.2%) of neutropenia in group within 24 hours and after 24 hours, 7 cases (12.7%), 3 cases (23.5%) of fever, 2 cases(3.6%), 1 case(4.2%) of infection and 6 cases (10.9%), 5 cases (20.9%) of antibiotics usage. 7 cases (3 patients, 12.7%) and 0 case of delay to next chemotherapy as a result of neutropenia were found. No statistical difference could be observed. There were more cases of multi-organ metastasis and antitumor agent dose reduction demands in patients’group who experienced neutropenia. These patients were at worse performance state, and were to be considered as more important factors that influenced neutropenia. Universal recommendation on optimal timing of CSF initiation cannot be made and no statistical difference was found in this study. In the future detailed classification of patients can be conducted in another experiments to enhance the study over this subject.
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KEYWORD
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Neutropenia, Colony-Stimulating Factor(CSF), optimal administration time
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