Colony-stimulating factors for febrile neutropenia during cancer therapy.
Colony-stimulating factors for febrile neutropenia during cancer therapy.
复制标题
DOI：
10.1056/nejmct1210890
复制
发表时间：
2013-03-21
期刊：
影响因子：
--
通讯作者：
Armitage JO
中科院分区：
文献类型：
--
作者：
Bennett CL;Djulbegovic B;Norris LB;Armitage JO
一名55岁的健康女性，在评估活检获得的左腋窝淋巴结肿大后，被诊断为弥漫性大B细胞淋巴瘤。除了她洗澡时发现的腋窝淋巴结肿大外，她一直没有症状。她被转诊给肿瘤学家，肿瘤学家进行了分期评估。全血细胞计数和肝肾功能及血清乳酸脱氢酶检查结果正常。正电子发射断层扫描和计算机断层扫描（PET-CT）发现左腋窝、纵隔和腹膜后淋巴结肿大伴异常摄取。骨髓活检结果正常。患者的肿瘤科医生建议使用环磷酰胺、多柔比星、长春新碱和泼尼松联合利妥昔单抗（CHOP-R）治疗6个周期，间隔21天。第一个化疗周期是否需要预防性使用粒细胞集落刺激因子（G-CSF）？
A 55-year-old, previously healthy woman received a diagnosis of diffuse large-B-cell lymphoma after the evaluation of an enlarged left axillary lymph node obtained on biopsy. She had been asymptomatic except for the presence of enlarged axillary lymph nodes, which she had found while bathing. She was referred to an oncologist, who performed a staging evaluation. A complete blood count and test results for liver and renal function and serum lactate dehydrogenase were normal. Positron-emission tomography and computed tomography (PET–CT) identified enlarged lymph nodes with abnormal uptake in the left axilla, mediastinum, and retroperitoneum. Results on bone marrow biopsy were normal. The patient’s oncologist recommends treatment with six cycles of cyclophosphamide, doxorubicin, vincristine, and prednisone with rituximab (CHOP-R) at 21-day intervals. Is the administration of prophylactic granulocyte colony-stimulating factor (G-CSF) with the first cycle of chemotherapy indicated?