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. 2022 May;61(5):537-551.
doi: 10.1007/s00120-022-01831-6. Epub 2022 Apr 27.

[G-CSF for prophylaxis of neutropenia and febrile neutropenia, anemia in cancer : Guidelines on supportive treatment part 1]

[Article in German]
Hartmut Link  1
Affiliations

[G-CSF for prophylaxis of neutropenia and febrile neutropenia, anemia in cancer : Guidelines on supportive treatment part 1]

[Article in German]
Hartmut Link. Urologe A. 2022 May.

Erratum in

Abstract
in English, German

Infections in patients with neutropenia following chemotherapy are mostly manifested as fever (febrile neutropenia, FN). Some of the most important determinants of the risk of FN are the type of chemotherapy, the dose intensity and patient-specific factors. When the risk of FN is 20% or more granulopoiesis is prophylactically stimulated with granulocyte colony stimulating factor (G-CSF) after the treatment. Anemia should always be clarified and if necessary be treated according to the cause when symptomatic. If an absolute or functional iron deficiency is present, intravenous iron substitution is mostly necessary. Erythropoiesis-stimulating agents can be used after chemotherapy with hemoglobin (Hb) levels less than 10 g/dl (6.2 mmol/l). In cases of chronic anemia and Hb levels less than 7-8 g/dl (<4.3-5.0 mmol/l) the indications for transfusion of erythrocyte concentrates should be assessed primarily based on the individual clinical symptoms.

Infektionen bei neutropenischen Patienten nach Chemotherapie manifestieren sich meistens durch Fieber (febrile Neutropenie, FN). Zu den wichtigsten Determinanten des FN-Risikos gehören der Chemotherapietyp, die Dosisintensität und patientenspezifische Faktoren. Bei einem FN-Risiko von 20 % oder höher wird die Granulopoese nach der Therapie prophylaktisch mit G‑CSF („granulocyte colony-stimulating factor“) stimuliert. Eine Anämie sollte immer abgeklärt und falls erforderlich entsprechend ihrer Ursache bei Anämiebeschwerden behandelt werden. Wenn ein absoluter oder funktioneller Eisenmangel vorliegt, dann ist meistens eine intravenöse (i.v.) Eisensubstitution erforderlich. Erythropoesestimulierende Substanzen können nach Chemotherapie bei Hämoglobin(Hb)-Werten unter 10 g/dl (6,2 mmol/l) verwendet werden. Bei chronischer Anämie und Hb-Werten unter 8–7 g/dl (< 5,0–4,3 mmol/l) sollte die Indikation für die Transfusion von Erythrozytenkonzentraten primär anhand der individuellen klinischen Symptomatik gestellt werden.

Keywords: Chemotherapy; Erythropoietin; Granulocyte colony-stimulating factor; Infections; Iron.

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References

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