Dr. Crawford on Managing Febrile Neutropenia

Jeffrey Crawford, MD, professor of medicine at Duke University Medical Center in Durham, North Carolina, discusses the importance of managing febrile neutropenia, which can often occur after the first cycle of many anticancer therapies.

Crawford explains that the risk for developing febrile neutropenia is highest in the first cycle of treatment. Additionally, it is difficult to measure an individual's risks until the first cycle is administered. There are guidelines to suggest risk, but individual factors such as liver and renal function, age, and prior treatments make determining risk difficult.

Complications of febrile neutropenia may lead to hospitalization, intravenous antibiotics, and a significant degree of mortality, according to a presentation by Crawford at the 2012 MASCC International Symposium. Febrile neutropenia remains the largest cause of death connected to an adverse reaction.

Crawford stresses that it is important for providers and those taking care of patients to be cognizant of the risks of febrile neutropenia when beginning treatment, especially when administering a full dose of chemotherapy.

The ASCO guidelines note a need to administer preventive pharmaceuticals if the level of risk is over 20%. Crawford believes that preemptive medications should be considered in the first-cycle for those at risk.

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