Neutropenia and Fever with Breast Cancer Chemotherapy

  • What is the most likely regimen that she received?
    • Dose-dense doxorubicin and cyclophosphamide.
    • Weekly paclitaxel and trastuzumab.
    • Docetaxel.
    • Cyclophosphamide, methotrexate, and 5-fluorouracil.
    • Gemcitabine.
  • The regimen in the list that is associated with a high risk for febrile neutropenia (> 20%) is:
    • Dose-dense doxorubicin and cyclophosphamide
  • The others listed are associated with a lower (less than 20%) risk of febrile neutropenia and thus do not require growth factor support in an otherwise healthy young patient lacking specific comorbidities

References

1. Smith TJ, Bohlke K, Lyman GH, Carson KR, Crawford J, Cross SJ, et al. Recommendations for the use of WBC growth factors: American Society of Clinical Oncology Clinical Practice Guideline update. J Clin Oncol. 2015;33(28):199-212.

2. Citron ML, Berry DA, Cirrincione C, Hudis C, Winer EP, Gradishar WJ, et al. Randomized trial of dose-dense versus conventionally scheduled and sequential versus concurrent combination chemotherapy as postoperative adjuvant treatment of node positive primary breast cancer: first report of Intergroup Trial C9741/Cancer and Leukemia Group B Trial 9741. J Clin Oncol. 2003;21(8):1431-1439.

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