Although white blood cell boosters, known as colony-stimulating factors, are available to manage neutropenia, researchers found that only a quarter of the patients received them during chemotherapy. Most were prescribed in reaction to neutropenia, rather than as a preventative or prophylactic measure.
"Far too many patients are not receiving the chemotherapy doses they need in order to have the best chance of remission or cure," said Lyman, director of the Awareness of Neutropenia in Chemotherapy Study Group at the Wilmot Cancer Center. "Much of the reduction in dose and overall reduced relative dose intensity compared to the reference standard was either planned or already seen during the first chemotherapy cycle. We need to find better ways to identify patients at risk in order to provide optimal supportive care."
The researchers note that these results are particularly alarming in the face of multiple, prior studies, which underscore the importance of maintaining full chemotherapy dose-intensity, especially in responsive and potentially curable malignancies like early stage breast cancer. Specific treatment regimen and schedule, age and obesity were also associated with an increased risk of treatment delays and dose reductions.
Elderly Patients at Greatest Risk
According to the study, an unusually large number of patients age 65 and older were found to be significantly less likely to receive the recommended dose of chemotherapy, even though studies have shown that elderly patients can benefit from chemotherapy as much as younger patients. In fact, about two-thirds of older patients receiv
Contact: Leslie White
University of Rochester Medical Center