ArticleSpringerPlus2015
The impact of chemotherapy dose intensity and supportive care on the risk of febrile neutropenia in patients with early stage breast cancer: a prospective cohort study.
Article in SpringerPlus, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 21 citations in OpenAlex.
- Hematologic Toxicities and Determinants Among Patients With Breast Cancer Treated With Doxorubicin-Cyclophosphamide Followed by Paclitaxel in Northwest Ethiopia: A Retrospective Cohort Study.Health science reports · 2026Article
- Timing and clinical burden of febrile neutropenia and treatment discontinuation during neoadjuvant chemotherapy.BMC cancer · 2026Article
- A prospective, real-world, multinational study of febrile neutropenia (FN) occurrence in oncology patients receiving chemotherapy with intermediate risk of FN: a MASCC Neutropenia, Infection, and Myelosuppression Study Group initiative.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023Observational
- All-Cause Mortality and Its Predictors in Haemato-Oncology Patients with Febrile Neutropenia.Journal of clinical medicine · 2023Article
- Article
- Validation of theDiscover oncology · 2022Article
- Overuse and underuse of pegfilgrastim for primary prophylaxis of febrile neutropenia.Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners · 2019Article
- Hematopoietic Growth Factors in the Management of Anemia and Febrile Neutropenia.Breast care (Basel, Switzerland) · 2019Review
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFebrile neutropenia (FN) is a major dose-limiting toxicity of cancer chemotherapy resulting in considerable morbidity, mortality, and cost. This study evaluated the time course of neutropenic events and patterns of supportive care interventions in patients receiving chemotherapy for early-stage breast cancer treated in oncology community practices.
methodsA prospective cohort study of adult cancer patients initiating a new chemotherapy regimen was conducted at 115 US sites. Toxicity associated with chemotherapy including neutropenic and infectious complications was recorded over four cycles. Clinical interventions were recorded including reductions in chemotherapy dose intensity and use of supportive care measures.
resultsA total of 1,202 patients with stage I-III breast cancer were evaluated. The majority of neutropenic (116 of 196) and infection events (179 of 325) occurred in the initial cycle. A decrease in occurrence of FN and infection was observed in the subsequent cycles, along with an increase in utilization of colony stimulating factors (CSFs), antibiotics and reductions in chemotherapy dose intensity. The overall risk of FN in all patients was 16.3%. In patients who started treatment at or near full dose intensity, the FN risk reached 21.0% without primary CSF prophylaxis and it was 9.0% with prophylaxis. There was no significant difference in FN rates by menopausal or hormone receptors status.
conclusionsThe risk of neutropenic complications is greatest in the initial cycle when most patients receive full-dose chemotherapy. A decrease in neutropenic events during subsequent cycles is associated with reduced dose intensity or increased use of supportive care measures. However, the cumulative risk of FN remains high in patients with early-stage breast cancer receiving full dose chemotherapy without prophylactic measures.
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