下载

2下载券

加入VIP
  • 专属下载特权
  • 现金文档折扣购买
  • VIP免费专区
  • 千万文档免费下载

上传资料

关闭

关闭

关闭

封号提示

内容

首页 2010NCCN骨髓生长因子使用指南

2010NCCN骨髓生长因子使用指南.pdf

2010NCCN骨髓生长因子使用指南

gard
2010-06-21 0人阅读 举报 0 0 暂无简介

简介:本文档为《2010NCCN骨髓生长因子使用指南pdf》,可适用于自然科学领域

ContinueNCCNClinicalPracticeGuidelinesinOncology™MyeloidGrowthFactorsVwwwnccnorgVersion,©NationalComprehensiveCancerNetwork,IncAllrightsreservedTheseguidelinesandthisillustrationmaynotbereproducedinanyformwithouttheexpresswrittenpermissionofNCCNPracticeGuidelinesinOncology–vGuidelinesIndexMyeloidGrowthFactorsTOCDiscussion,ReferencesMyeloidGrowthFactorsNCCN®NCCNMyeloidGrowthFactorsPanelMembersJeffreyCrawford,MDChairDukeComprehensiveCancerCenterJeffreyAllen,MDJamesArmitage,MDLodovicoBalducci,MDHLeeMoffittCancerCenterandResearchInstituteCharlesBennett,MD,PhD,MPPRobertHLurieComprehensiveCancerCenterofNorthwesternUniversityDouglasWBlayney,MDUniversityofMichiganComprehensiveCancerCenter†‡†StJudeChildren'sResearchHospitalUniversityofTennesseeCancerInstituteÞ†‡†‡Þ†‡‡UNMCEppleyCancerCenteratTheNebraskaMedicalCenterSperoRCataland,MDTheOhioStateUniversityComprehensiveCancerCenterJamesCancerHospitalandSoloveResearchInstituteDavidCDale,MDFredHutchinsonCancerResearchCenterSeattleCancerCareAllianceGaryHLyman,MD,MPHSarahCMiyata,RN,MSN,ACNPCSRobertHLurieComprehensiveCancerCenterofNorthwesternUniversityMartinSTallman,MDRobertHLurieComprehensiveCancerCenterofNorthwesternUniversitySarojVadhanRaj,MDTheUniversityofTexasMDAndersonCancerCenterPeterWestervelt,MD,PhDSitemanCancerCenteratBarnesJewishHospitalandWashingtonUniversitySchoolofMedicineMichaelWestmoreland,PharmDTheUniversityofTexasMDAndersonCancerCenterMichaelKWong,MD,PhDRoswellParkCancerInstitute†‡DukeComprehensiveCancerCenter#‡Þ††�*†Medicaloncology‡HematologyHematologyoncologyÞInternalmedicineInfectiousdiseasesPharmacology#Nursing��*WritingCommitteeMemberGeorgeDDemetri,MDDanaFarberBrighamandWomen’sCancerCenterHarryPErba,MD,PhDUniversityofMichiganComprehensiveCancerCenterJamesForan,MDUniversityofAlabamaatBirminghamComprehensiveCancerCenterMartiGoemann,RPhVanderbiltIngramCancerCenterMarkLHeaney,MD,PhDMemorialSloanKetteringCancerCenterSallyHtoy,PharmDCityofHopeComprehensiveCancerCenterSusanHudock,PharmDTheSidneyKimmelComprehensiveCancerCenteratJohnsHopkinsDwightDKloth,PharmDFoxChaseCancerCenterDavidJKuter,MD,DPhilMassachusettsGeneralHospitalCancerCenter††‡††‡Þ†‡���ContinueNCCNGuidelinesPanelDisclosuresVersion,©NationalComprehensiveCancerNetwork,IncAllrightsreservedTheseguidelinesandthisillustrationmaynotbereproducedinanyformwithouttheexpresswrittenpermissionofNCCNPracticeGuidelinesinOncology–vGuidelinesIndexMyeloidGrowthFactorsTOCDiscussion,ReferencesMyeloidGrowthFactorsNCCN®TheseguidelinesareastatementofevidenceandconsensusoftheauthorsregardingtheirviewsofcurrentlyacceptedapproachestotreatmentAnyclinicianseekingtoapplyorconsulttheseguidelinesisexpectedtouseindependentmedicaljudgmentinthecontextofindividualclinicalcircumstancestodetermineanypatient’scareortreatmentTheNationalComprehensiveCancerNetworkmakesnorepresentationsorwarrantiesofanykind,regardingtheircontentuseorapplicationanddisclaimsanyresponsibilityfortheirapplicationoruseinanywayTheseguidelinesarecopyrightedbyNationalComprehensiveCancerNetworkAllrightsreservedTheseguidelinesandtheillustrationshereinmaynotbereproducedinanyformwithouttheexpresswrittenpermissionofNCCN©TableofContentsNCCNMyeloidGrowthFactorsPanelMembersEvaluation,RiskAssessmentandProphylacticTherapy(MGFEvaluationPriortoSecondandSubsequentChemotherapyCycles(MGFExamplesofChemotherapyRegimensandRiskofFebrileNeutropenia(MGFAPatientRiskFactorsforFebrileNeutropenia(MGFBGuidelinesIndexPrinttheMyeloidGrowthFactorsGuidelineSummaryoftheGuidelinesUpdates))))TherapeuticUseofCSFForFebrileNeutropenia(MGFDiseaseSettingsand)DevelopingMyeloidGrowthFactorsforProphylaxisandTreatmentofFebrileNeutropeniaandMaintenanceofScheduledDoseDelivery(MGFCToxicityRiskswithGrowthFactors(MGFDPatientRiskFactorsforPoorClinicalOutcomesorforDevelopingInfectionAssociatedComplications(MGFE)))ClinicalTrials:CategoriesofEvidenceandConsensus:NCCNThebelievesthatthebestmanagementforanycancerpatientisinaclinicaltrialParticipationinclinicaltrialsisespeciallyencouragedTofindclinicaltrialsonlineatNCCNmemberinstitutions,AllrecommendationsareCategoryAunlessotherwisespecifiedSeeNCCNclickhere:nccnorgclinicaltrialsphysicianhtmlNCCNCategoriesofEvidenceandConsensusForhelpusingthesedocuments,pleaseclickhereDiscussionReferencesVersion,©NationalComprehensiveCancerNetwork,IncAllrightsreservedTheseguidelinesandthisillustrationmaynotbereproducedinanyformwithouttheexpresswrittenpermissionofNCCNPracticeGuidelinesinOncology–vGuidelinesIndexMyeloidGrowthFactorsTOCDiscussion,ReferencesMyeloidGrowthFactorsNCCN®SummaryoftheGuidelinesupdatesUPDATESMGFMGFMGFBMGFCMGFDMGFE�������Footnotel,“Doselimitingneutropeniceventcouldbeanadircountordayoftreatmentcountthatmayotherwiseimpactplanneddoseofchemotherapy”Footnote‘p’wasmodifiedas,“Therearenostudieswhichhaveaddressedtherapeuticuseofforfebrileneutropenia”Firstbullet,“Olderpatient,notablypatientsageandolder”wasmodifiedbyaddingalink,“SeeNCCNSeniorAdultOncologyGuidelines”Footnote,wasmodifiedas,“RandomizedphaseIItrialsofpegfilgrastimadministrationthesamedayaschemotherapyversusadministrationthedayafterchemotherapyhaveshownanincreaseinfebrileneutropeniaandorotheradverseeventsSeediscussionfordetails”Footnote,“Toxicitydataarebasedprimarilyonstudiesfromleukemiaandtransplantpatients”isnewtothepage“Priorepisodeoffebrileneutropenia”wasaddedasapatientriskfactorforpoorclinicaloutcomeorfordevelopinginfectionassociatedcomplicationsfilgrastiminpatientswhohavealreadyreceivedprophylacticpegfilgrastim�MGFAofRegimensathighriskoffebrileneutropenia,thefollowingwereadded:“HyperCVAD”fortreatmentofmultiplemyeloma“Antithymocyteglobulin,rabbitcyclosporine”fortreatmentofmyelodysplasticsyndrome“Doxorubicingemcitabine”fortreatmentofkidneycancer��SummaryofthechangesintheversionoftheMyeloidGrowthFactorsGuidelinesfromtheversioninclude:Version,©NationalComprehensiveCancerNetwork,IncAllrightsreservedTheseguidelinesandthisillustrationmaynotbereproducedinanyformwithouttheexpresswrittenpermissionofNCCNPracticeGuidelinesinOncology–vGuidelinesIndexMyeloidGrowthFactorsTOCDiscussion,ReferencesMyeloidGrowthFactorsNCCN®Note:AllrecommendationsarecategoryAunlessotherwiseindicatedClinicalTrials:NCCNbelievesthatthebestmanagementofanycancerpatientisinaclinicaltrialParticipationinclinicaltrialsisespeciallyencouragedRISKASSESSMENTFORFEBRILENEUTROPENIAcMGFEvaluationofriskforfebrileneutropeniafollowingchemotherapyinadultpatientswithsolidtumorsandnonmyeloidmalignanciesb�Disease�Chemotherapyregimend�Highdosetherapy�Dosedensetherapy�Standarddosetherapy�Patientriskfactorsd�Treatmentintent(curativevspalliative)EVALUATIONPRIORTOFIRSTCHEMOTHERAPYCYCLEaCHEMOTHERAPYTREATMENTINTENTCURATIVEADJUVANThPROLONGSURVIVALQUALITYOFLIFESYMPTOMMANAGEMENTQUALITYOFLIFEHigh(>)eIntermediate()Low(<)CSF(categoryforGCSF)iCSFkConsiderCSFConsiderCSFkNoCSFNoCSFNoCSFjSeeEvaluationPriortoSecondorSubsequentChemotherapyCycles(MGF)PROPHYLACTICUSEOFCSFFORFEBRILENEUTROPENIAc,f,gConsiderCSFkCSF(categoryforGCSF)iabcdefTheNCCNMyeloidGrowthFactorsGuidelineswereformulatedinreferencetoadultpatientsForuseofgrowthfactorsinMyelodysplasticSyndromes,ForuseofgrowthfactorsinAcuteMyeloidLeukemia,Febrileneutropeniaisdefinedas,sOnecriterionthatplacesapatientathighriskisapreviousneutropeniccomplicationintheimmediatepreviouscyclewithnoplantoreducedoseintensityThistableappliestoprophylaxisforthefirstcycleofchemotherapyforsolidtumorsandnonmyeloidmalignanciesingletemperature:°Corallyor°Coverhneutropenia:<neutrophilsmcLor<,neutrophilsmcLandapredicteddeclinetomcLoverthenexth���Therearemanyfactorsthatneedtobeevaluatedtodetermineapatient’sriskcategorizationtheseincludetypeofchemotherapyregimen()andpatientriskfactors()seetheNCCNMyelodysplasticGuidelinesseetheNCCNAcuteMyeloidLeukemiaGuidelinesSeeToxicityRisksWithGrowthFactors(MGFDSeetheNCCNPreventionandTreatmentofCancerRelatedInfectionsGuidelinesSeeDiseaseSettingsandExamplesofChemotherapyRegimensandRiskofFebrileNeutropeniaMGFASeePatientRiskFactorsforDevelopingFebrileNeutropeniaMGFBSeeMyeloidGrowthFactorsforProphylaxisandTreatmentofFebrileNeutropeniaandMaintenanceofScheduledDoseDelivery(MGFC))gCSF=ColonystimulatingfactorshTheconfoundingeffectsofanthracyclineandalkylatingagentdose,radiationdoseandfieldsize,andcolonystimulatingfactorsuseontheslightexcessriskofleukemiaandMDSinpatientstreatedwiththeseagentsandmodalitiesarecurrentlyunquantifiedTheassociatedriskofleukemiaandMDShasbeensuggestedbyepidemiologicstudies,buthasnotbeenobservedintheavailableprospectiverandomizedstudiesijkThereiscategoryevidenceforGCSFforareductionof:riskoffebrileneutropenia,hospitalization,intravenousantibioticsduringthecourseoftherapyThereiscategoryAevidenceforGCSFforareductionininfectionrelatedmortalityduringthecourseoftreatment(Seediscussionforfurtherdetail)OnlyconsiderCSFifpatientsareatsignificantriskforseriousmedicalconsequencesoffebrileneutropenia,includingdeathTheuseofCSFinthissettingisadifficultdecisionandrequirescarefuldiscussionbetweenthephysicianandthepatientIfpatientriskfactorsdeterminetheriskis,CSFisreasonableHowever,iftheriskisduetothechemotherapyregimen,otheralternativessuchastheuseoflessmyelosuppressivechemotherapyordosereduction,ifofcomparablebenefit,shouldbeexploredVersion,©NationalComprehensiveCancerNetwork,IncAllrightsreservedTheseguidelinesandthisillustrationmaynotbereproducedinanyformwithouttheexpresswrittenpermissionofNCCNPracticeGuidelinesinOncology–vGuidelinesIndexMyeloidGrowthFactorsTOCDiscussion,ReferencesMyeloidGrowthFactorsNCCN®Note:AllrecommendationsarecategoryAunlessotherwiseindicatedClinicalTrials:NCCNbelievesthatthebestmanagementofanycancerpatientisinaclinicaltrialParticipationinclinicaltrialsisespeciallyencouragedMGFEVALUATIONPRIORTOSECONDANDSUBSEQUENTCHEMOTHERAPYCYCLESNofebrileneutropeniaordoselimitingneutropeniceventclFebrileneutropeniaordoselimitingneutropeniceventclPrioruseofCSFNoprioruseofCSFConsiderdosereductionorchangeintreatmentregimenRepeatassessmentaftereachsubsequentcycleConsiderCSF)(SeeMGFRiskAssessmentForFebrileNeutropeniaEvaluatepatientpriortosecondandsubsequentchemotherapycyclesSECONDARYPROPHYLAXIScFebrileneutropeniaisdefinedas,singletemperature:°Corallyor°Coverhneutropenia:<neutrophilsmcLor<,neutrophilsmcLandapredicteddeclinetomcLoverthenexthDoselimitingneutropeniceventcouldbeanadircountordayoftreatmentcountthatmayotherwiseimpactplanneddoseofchemotherapy���lSeeNCCNPreventionandTreatmentofCancerRelatedInfectionsGuidelinesVersion,©NationalComprehensiveCancerNetwork,IncAllrightsreservedTheseguidelinesandthisillustrationmaynotbereproducedinanyformwithouttheexpresswrittenpermissionofNCCNPracticeGuidelinesinOncology–vGuidelinesIndexMyeloidGrowthFactorsTOCDiscussion,ReferencesMyeloidGrowthFactorsNCCN®Note:AllrecommendationsarecategoryAunlessotherwiseindicatedClinicalTrials:NCCNbelievesthatthebestmanagementofanycancerpatientisinaclinicaltrialParticipationinclinicaltrialsisespeciallyencouragedMANAGEMENTOFPATIENTSWITHFEBRILENEUTROPENIAc,mPatientsreceivingCSF(filgrastimorsprophylacticargramostim)PatientswhohavereceivedpegfilgrastimprophylacticPatientswhodidnotreceiveCSFprophylacticRiskfactorsnotpresentoforaninfectionassociatedcomplicationRiskfactorspresentforaninfectionassociatedcomplicationoContinueCSFNoadditionalCSFpNoCSFConsiderCSFqcopFebrileneutropeniaisdefinedas,singletemperature:°Corallyor°Coverhneutropenia:<neutrophilsmcLor<,neutrophilsmcLandapredicteddeclinetomcLoverthenexthForantibiotictherapyrecommendationsforfeverandneutropenia,ThedecisiontouseCSFinthetherapeuticsettingiscontroversialSeediscussionforfurtherdetailTherearenostudieswhichhaveaddressedtherapeuticuseoffilgrastimforfebrileneutropeniainpatientswhohavealreadyreceivedprophylacticpegfilgrastimHowever,pharmacokineticdataofpegfilgrastimdemonstratedhighlevelsduringneutropeniaandsuggeststhatadditionalCSFwillnotbebeneficialhereisnodataonpegfilgrastimintherapeuticsettingEitherfilgrastimorsargramostimshouldbeusedwithinitialdosingasoutlinedonanddiscontinuedattimeofneutrophilrecovery���mnqSeediscussionforfurtherdetailTSeetheNCCNPreventionandTreatmentofCancerRelatedInfectionsGuidelinesseetheNCCNPreventionandTreatmentofCancerRelatedInfectionsGuidelinesSeePatientRiskFactorsforPoorClinicalOutcomesorforDevelopingInfectionAssociatedComplications(MGFEMyeloidGrowthFactorsforProphylaxisandTreatmentofFebrileNeutropeniaandMaintenanceofScheduledDoseDelivery(MGFC))THERAPEUTICUSEOFCFORFEBRILENEUTROPENIAc,m,nSFCSFUSEDURINGCURRENTCHEMOTHERAPYCYCLEMGFPresentwithfebrileneutropeniacPRESENTATIONVersion,©NationalComprehensiveCancerNetwork,IncAllrightsreservedTheseguidelinesandthisillustrationmaynotbereproducedinanyformwithouttheexpresswrittenpermissionofNCCNPracticeGuidelinesinOncology–vGuidelinesIndexMyeloidGrowthFactorsTOCDiscussion,ReferencesMyeloidGrowthFactorsNCCN®Note:AllrecommendationsarecategoryAunlessotherwiseindicatedClinicalTrials:NCCNbelievesthatthebestmanagementofanycancerpatientisinaclinicaltrialParticipationinclinicaltrialsisespeciallyencouragedMGFAofExamplesofDiseaseSettingsandChemotherapyRegimenswithaHighRiskofFebrileNeutropenia(>)SeeChemotherapyRegimenswithanIntermediateRiskofFebrileNeutropeniaMGFA(ofDiseaseSettingsand)SeeChemotherapyRegimenReferencesMGFA(of)�����Thislistisnotcomprehensive,thereareotheragentsregimensthathaveahighriskforthedevelopmentoffebrileneutropeniaTheexactriskincludesagent,dose,andthetreatmentsetting(ie,treatmentnaiveversusheavilypretreatedpatients)()ThetypeofchemotherapyregimenisonlyonecomponentoftheRiskAssessment()PegfilgrastimhasnotbeendocumentedtohavebenefitinregimensgivenunderaweekdurationNote:Thereferenceslistedforeachregimenarelimitedbythespecificpopulationsstudied,methods,andcollectionofdataforfebrileneutropeniaintheclinicaltrialSeeMGFSeePatientRiskFactorsforDevelopingFebrileNeutropeniaMGFB*Ingeneral,dosedenseregimensrequiregrowthfactorsupportforchemotherapyadministrationBladderCancerBreastCancerKidneyCancerNonHodgkin'sLymphomaMelanoma��������������������������MVAC(methotrexate,vinblastine,doxorubicin,cisplatin)(neoadjuvant,adjuvant,metastatic)Docetaxeltrastuzumab(metastaticorrelapsed)DosedenseACT*(doxorubicin,cyclophosphamide,paclitaxel)(adjuvant)AT(doxorubicin,paclitaxel)(metastaticorrelapsed)AT(doxorubicin,docetaxel)(metastaticorrelapsed)TAC(docetaxel,doxorubicin,cyclophosphamide)(adjuvant)ICE(ifosfamide,carboplatin,etoposide)(DiffuseLargeBCellLymphoma,PeripheralTcellLymphomas,ndline,salvage)RICE(rituximab,ifosfamide,carboplatin,etoposide)CHOP*(cyclophosphamide,doxorubicin,vincristine,prednisone)MINE(mesna,ifosfamide,novantroneandetoposide)(DiffuseLargeBCellLymphoma,PeripheralTcellLymphomas,ndline,refractory)DHAP(dexamethasone,cisplatin,cytarabine)(PeripheralTcellLymphomas,DiffuseLargeBCellLymphoma,ndline)ESHAP(etoposide,methylprednisolone,cisplatin,cytarabine)(DiffuseLargeBCellLymphoma,PeripheralTcellLymphoma,ndline,recurrent)BEACOPP(bleomycin,etoposide,doxorubicin,cyclophosphamide,vincristine,procarbazine,prednisone)HyperCVADr(cyclophosphamide,vincristine,doxorubicin,dexamethasoner)Dacarbazinebasedcombination(dacarbazine,cisplatin,vinblastine)(advanced,metastatic,orrecurrent)DacarbazinebasedcombinationwithIL,interferonalfa(dacarbazine,cisplatin,vinblastine,IL,interferonalfa)(advanced,metastatic,orrecurrent)TopotecanPaclitaxelDocetaxelGemcitabineMAID(mesna,doxorubicin,ifosfamide,dacarbazine)DoxorubicinVeIP(vinblastine,ifosfamide,cisplatin)VBEP(bleomycin,etoposide,cisplatin,EsophagealandGastricCancerDocetaxelcisplatinfluorouracilAntithymocyteglobulin,rabbitcyclosporineDoxorubicingemcitabineModifiedHyperCVADDecitabinedocetaxelrTopotecan)TIP(paclitaxel,ifosfamide,cisplatin)*ituximabituximabMultipleMyelomaMyelodysplasticsyndromeOvarianCancerPancreaticCancerSarcomaSmallCellLungCanceTesticularCancer�����IP(etoposide,ifosfamide,cisplatin)�Version,©NationalComprehensiveCancerNetwork,IncAllrightsreservedTheseguidelinesandthisillustrationmaynotbereproducedinanyformwithouttheexpresswrittenpermissionofNCCNPracticeGuidelinesinOncology–vGuidelinesIndexMyeloidGrowthFactorsTOCDiscussion,ReferencesMyeloidGrowthFactorsNCCN®ExamplesofChemotherapyRegimenswithanIntermediateRiskofFebrileNeutropenia()DiseaseSettingsandMGFAofNote:AllrecommendationsarecategoryAunlesso

用户评价(0)

关闭

新课改视野下建构高中语文教学实验成果报告(32KB)

抱歉,积分不足下载失败,请稍后再试!

提示

试读已结束,如需要继续阅读或者下载,敬请购买!

文档小程序码

使用微信“扫一扫”扫码寻找文档

1

打开微信

2

扫描小程序码

3

发布寻找信息

4

等待寻找结果

我知道了
评分:

/27

2010NCCN骨髓生长因子使用指南

VIP

在线
客服

免费
邮箱

爱问共享资料服务号

扫描关注领取更多福利