21. Neulasta -- Facts About Neutropenia neutropenia A SERIOUS AND FREQUENT CHEMOTHERAPY SIDE EFFECT Many cancer patientsworry about possible side effects of chemotherapy. What is neutropenia? http://www.neulasta.com/facts_neutropenia.html

NEUTROPENIA: A SERIOUS AND FREQUENT CHEMOTHERAPY SIDE EFFECT Many cancer patients worry about possible side effects of chemotherapy. A Roper Starch survey of chemotherapy patients found that, prior to starting treatment, 32 percent reported surviving cancer as their biggest concern versus 40 percent who said side effects were their biggest concern. This concern is warranted, as about half of cancer chemotherapy patients develop a condition called neutropenia (new-tro-pee-nee-uh) i that can place them at risk for life-threatening infections. Infections may require hospitalization and can delay chemotherapy treatment and reduce its effectiveness. What is neutropenia? Neutropenia is a severe drop in infection-fighting white blood cells (neutrophils). A common side effect of some kinds of chemotherapy, neutropenia is serious because: Thousands of patients are hospitalized for neutropenia each year. This in an age when many cancer patients receive chemotherapy treatment as outpatients. The majority of patients with certain tumors who develop neutropenia will either have their chemotherapy postponed or their dose decreased, both of which can reduce survival rates. ii,iii

22. NEUPOGEN® Filgrastim How neutropenia can affect your successful chemotherapy neutropenia (newtro-pee-nee-uh)is the medical word for low white blood cell count. http://www.neupogen.com/patients/overview/neutropenia.html

How neutropenia can affect your successful chemotherapy Neutropenia (new-tro- pee -nee-uh) is the medical word for low white blood cell count. It can be a very serious condition, because white blood cells protect your body from infections. Without enough white blood cells to protect you, even a small infected cut could become life-threatening. Your doctor checks to see if you have neutropenia every time you get a blood test. If you are neutropenic, every precaution will be taken to avoid infection, even if no signs of infection are present. Your doctor may prescribe NEUPOGEN (Filgrastim), a medication that stimulates your body to produce more white blood cells. Even with the support of drugs like NEUPOGEN there may be times when chemotherapy will have to be reduced or delayed until your white blood cell count returns to normal levels. This delay is to be avoided if possible. Research has shown that with some tumor types, getting the prescribed dose of chemotherapy on time, every time, is important to increase the chance of survival. It is for this very reason that some doctors prescribe NEUPOGEN at the start of chemotherapy, as a preventative step against the potential complications of neutropenia.

23. National Neutropenia Network, Inc. http://www.neutropenia.org/

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24. Neutropenia: BC Cancer Agency Agency Home Patient/Public Info Recommended Links Cancer RelatedWebsites neutropenia. Recommended Links. Myeloma. neutropenia. Nutrition. http://www.bccancer.bc.ca/PPI/RecommendedLinks/CancerRelatedWebsites/Neutropenia

Agency Links: Home Contact Us Legal Privacy ... Cancer Related Websites Neutropenia Recommended Links Cancer Related Websites Aplastic Anemia Breast ... Myeloma Neutropenia Nutrition Ovary Palliative Care Pancreas ... Other Health Websites Cancer Related Websites - Neutropenia Print Wizard Print this Page Neutropenia Support Association, Inc. Print Wizard ... Print this Page The BC Cancer Agency is a part of the Provincial Health Services Authority If you notice a problem with this page, please report it via the Bug Report Form . Thank you. Unofficial document if printed . Please refer to the following web address for up-to-date information:

25. Febrile Neutropenia: BC Cancer Agency Agency Home Health Professionals Info Cancer Management Guidelines SupportiveCare Febrile neutropenia. Supportive Care. Febrile neutropenia. http://www.bccancer.bc.ca/HPI/CancerManagementGuidelines/SupportiveCare/FebrileN

Agency Links: Home Contact Us Legal Privacy ... Supportive Care Febrile Neutropenia Supportive Care Febrile Neutropenia Pediatric SolidTumour Chronic Ulcerating Malignant Skin Lesions Nutritional Care ... Radiation Skin Reactions Supportive Care - Febrile Neutropenia Print Wizard Print this Page 1. Solid Tumour Leukemia/Bone Marrow Transplant Pediatric Patient Information Print Wizard ... Print this Page The BC Cancer Agency is a part of the Provincial Health Services Authority If you notice a problem with this page, please report it via the Bug Report Form . Thank you. Unofficial document if printed . Please refer to the following web address for up-to-date information:

26. AmgenTrials.com - Neutropenia Pediatric Sarcoma The purpose of this study is to determine the safety and effectivenessof pegfilgrastim in preventing neutropenia following chemotherapy in http://www.amgentrials.com/patients/blood_disorders/blood_neutropenia.htm

27. AmgenTrials.com - Neutropenia neutropenia following chemotherapy in patients up through the age of 21 with sarcoma.Heathcare Professionals click here. 1 866- 57AMGEN (1-866-572-6436). http://www.amgentrials.com/patients/pediatric_care/pediatric_neutropenia.htm

28. Neutropenia Causes neutropenia Causes Agranulocytosis Causes. Book, Home Page. InfectionSee Infectious Causes of neutropenia. Causes Increased Neutrophil http://www.fpnotebook.com/HEM92.htm

Home About Links Index ... Editor's Choice Paid Advertisement (click above). Please see the privacy statement Hematology and Oncology Laboratory Anemia ... Mean Platelet Volume Assorted Pages Acid Phosphatase Complete Blood Count Pancytopenia Hematocrit ... Medication Causes of Neutropenia Neutropenia Causes Agranulocytosis Causes Book Home Page Cardiovascular Medicine Dental Dermatology Emergency Medicine Endocrinology Gastroenterology General Medicine Geriatric Medicine Gynecology Hematology and Oncology HIV Infectious Disease Jokes Laboratory Neonatology Nephrology Neurology Obstetrics Ophthalmology Orthopedics Otolaryngology Pediatrics Pharmacology Prevention Psychiatry Pulmonology Radiology Rheumatology Sports Medicine Surgery Urology Chapter Hematology and Oncology Index Anemia Cancer Coagulopathy Cardiovascular Medicine Dermatology Endocrinology Otolaryngology Examination Gastroenterology Hematology and Oncology Hemoglobin Hemolysis Histiocytosis HIV Infectious Disease Laboratory Leukemia General Pulmonology Lymph Marrow Neurology Obstetrics Orthopedics Pediatrics Pharmacology Platelet Prevention Procedure Psychiatry Rheumatology Surgery Symptom Evaluation Vascular Page Laboratory Index Acid Phosphatase serum Anemia Ferritin Anemia Folate RBC Anemia Iron Serum Anemia Protoporphyrin Anemia Reticulocyte Count Anemia Sucrose Hemolysis Test Anemia TIBC Anemia Transferrin Anemia Transferrin Saturation Cancer Marker CA125 CBC CBC Pancytopenia CBC Hematocrit CBC Hemoglobin CBC MCHC CBC MCV CBC RBC CBC RBC Morphology CBC RDW CBC WBC CBC WBC Leukocytosis

29. Vitamin K Medication Causes of neutropenia neutropenia due to Medication. DrugInducedAgranulocytosis. Drug-Induced neutropenia. http://www.fpnotebook.com/HEM181.htm

Home About Links Index ... Editor's Choice Paid Advertisement (click above). Please see the privacy statement Hematology and Oncology Pharmacology Anemia ... t-PA Vitamin K Laboratory Medication Causes of Neutropenia Lymph Medication Causes of Lymphadenopathy Assorted Pages Chemotherapy Alkylating Agent Antibiotic chemotherapy Antimetabolite Chemotherapy ... Hematology Medications in Pregnancy Vitamin K Book Home Page Cardiovascular Medicine Dental Dermatology Emergency Medicine Endocrinology Gastroenterology General Medicine Geriatric Medicine Gynecology Hematology and Oncology HIV Infectious Disease Jokes Laboratory Neonatology Nephrology Neurology Obstetrics Ophthalmology Orthopedics Otolaryngology Pediatrics Pharmacology Prevention Psychiatry Pulmonology Radiology Rheumatology Sports Medicine Surgery Urology Chapter Hematology and Oncology Index Anemia Cancer Coagulopathy Cardiovascular Medicine Dermatology Endocrinology Otolaryngology Examination Gastroenterology Hematology and Oncology Hemoglobin Hemolysis Histiocytosis HIV Infectious Disease Laboratory Leukemia General Pulmonology Lymph Marrow Neurology Obstetrics Orthopedics Pediatrics Pharmacology Platelet Prevention Procedure Psychiatry Rheumatology Surgery Symptom Evaluation Vascular Page Pharmacology Index Anemia Anemia B12 Anemia Erythropoietin Anemia Iron Anemia Iron Parenteral Chemotherapy Chemotherapy Alkylating Chemotherapy Antibiotic Chemotherapy Antimetabolite Chemotherapy Hormone Chemotherapy Imuran Chemotherapy Plant Chemotherapy Protocol AC Chemotherapy Protocol CMF Coags Coags Coumadin

30. Febrile Neutropenia Febrile neutropenia Febrile neutropenia, http://www.rcpa.edu.au/pathman/febrile_.htm

Febrile neutropenia Febrile neutropenia FBC with differential WCC blood culture Bacterial Septicaemia eg Pseudomonas aeruginosa Enterobacter aerogenes Staphylococcus aureus Enterococcus faecalis Pneumonia esp Sputum microscopy and culture Streptococcus pneumoniae Haemophilus influenzae Lung infiltrate, lesion eg Aspergillus sp Bronchial brush, wash: bronchoalveolar lavage if response to appropriate empirical antibiotic regimen has not occurred. Mouth, oesophageal ulceration esp If response to initial therapy is unsatisfactory: endoscopy with biopsy for microscopy, culture for yeasts, viral detection, culture. Candida albicans See Candidiasis Herpes simplex virus See Herpes simplex virus infection Cytomegalovirus See Cytomegalovirus infection Cellulitis eg Aspirate from cellulitic area - microscopy and culture, incl fungal culture. Streptococcus pyogenes Aeromonas hydrophila Mucor sp Cannula site infection esp Wound swab of cannula site. Culture tip of intravenous cannula. Staphylococcus aureus Corynebacterium jeikeium

31. Neutropenia neutropenia up. Blood problems, One in a series of leaflets Severechronic neutropenia, This leaflet, aimed at parents, provides http://omni.ac.uk/browse/mesh/detail/C0027947L0027947.html

Neutropenia [up] Blood problems One in a series of leaflets produced by the National AIDS Manual (NAM), a UK community-based information provider, aimed at people with HIV or AIDS. This leaflet explains the problems that can arise as a result of HIV infection. The main blood problems (apart from a drop in CD4 cells) for people with HIV are anaemia, neutropenia and thrombocytopenia, which are discussed here. Provided on the web by a joint project between NAM, the British HIV Association, and the St. Stephen's AIDS Trust. Acquired Immunodeficiency Syndrome Anemia HIV Neutropenia ... Severe chronic neutropenia This leaflet, aimed at parents, provides information about Severe Chronic Neutropenia (SCN), a rare disease that affects the white cells in the blood. It explains the diagnosis, effects and treatment. The four major types of SCN: congenital, cyclical, idiopathic and autoimmune, are also defined. Published on the Web by Great Ormond Street Children's Hospital (GOSH) and the Institute of Child Health (ICH). Also available in PDF requiring Adobe Acrobat Reader. Child Neutropenia Patient Education Handout [Publication Type] Last modified 28/Mar/2003 [Low Graphics]

32. Neutropenia: Patient Information: Arizona Telemedicine Program neutropenia. A. What Is neutropenia? neutropenia is a decreased number of neutrophilsin the blood. In addition, neutropenia may be related to alcoholism. http://www.telemedicine.arizona.edu/patient_info/benign_disorders/disorders/neut

Patient Information Resource: Benign Hematologic (Blood) Disorders A collaborative project of the Arizona Telemedicine Program , the Arizona Health Sciences Library and the Arizona Cancer Center See: Neutropenia A. What Is Neutropenia? Neutropenia is a decreased number of neutrophils in the blood. Neutrophils are a type of white blood cell (WBC). Together, the WBCs are responsible for the immune response, the fighting of infection. There are many different kinds of WBCs, each with their own particular action. The neutrophils function by leaving the blood to destroy bacteria and fungi in the cells. Without enough neutrophils to fight these invading cells, infection results. Neutrophils are produced in the bone marrow and removed from the blood by the spleen. Therefore, blood levels can be low because of insufficient production in the marrow, excessive destruction in the blood or cells, or increased removal from the blood by the spleen. B. Causes

33. BioSpace : CCIS : Search Results For Indication = 'Neutropenia' 18 Search Results for Indication = 'neutropenia'. Patients See Clinical ResearchStudies currently enrolling patients for neutropenia. View as worksheet. http://www.biospace.com/ccis/search.cfm?RXTargetID=157

34. BioSpace News: Neutropenia BioSpace News neutropenia. ScheringPlough Corporation (SGP) To Acquire From Novartis(NVS) International Marketing Rights To Leucomax KENILWORTH, NJ, Oct. http://www.biospace.com/ccis/news_rxtarget.cfm?RXTargetID=157

35. Neutropenia SIG: My SIG Page February 6, 2003, neutropenia SIG, Our office has moved! Get information onthe new ONS Building by clicking here. neutropenia SIG Upconing Events, http://neutropenia.ons.wego.net/

var group_id =11409 var brand_id =148 var page_id =4918 New Users Log In Contact Us Help ... The SIGnal March 31, 2003 Neutropenia SIG At this SIG Virtual Community, you will find information pertaining your ONS SIG. Here, you can view myriad SIG resources; download and complete pertinent SIG documents; and join in our discussions. Welcome to our SIG online. As a SIG participant, you do not need to log in or join. Simply click your destination below, or one of the menu items, to begin taking part in the SIG Virtual Community activities. Subpages may be found on the left menu on applicable pages. The ONS Main SIG Page is updated frequently, so please check it often for timely announcements, documents, and other important SIG related information. (Click HERE to return to ONS ONLINE. Neutropenia SIG's Announcements Join Us for our Planning/Networking Meeting at Congress 2003! Join us at our Planning/Networking Meeting on Thursday, May 1, 2003 from 5:15-6:45 p.m. We will meet in Room 210C in the Colorado Convention Center. Please come and bring your ideas and suggestions! Call for Candidates!

36. Hematologic Toxicities Resource Area neutropenia White blood cells protect us from infection. neutropenia occurswhen the number of neutrophils circulating in the blood is too low. http://onsopcontent.ons.org/Toolkits/Amgen/neutropeniahome.html

Home > Neutropenia Links Patient Education NEUTROPENIA Bibliography Continuing Education In the News Let's Talk About It ... THROMBOCYTOPENIA Neutropenia White blood cells protect us from infection. Several kinds of white cells exist, and each has a special function. The two most most common types are Neutrophils , which surround and destroy bacteria in the body, and lymphocytes , which are the key part of the body’s immune system and defend against viruses. Neutropenia occurs when the number of neutrophils circulating in the blood is too low. Neutrophils are very important in defending the body against bacterial infections. Patients with too few neutrophils are more susceptible to infections. Neutropenia affects as many as one in three patients receiving chemotherapy for cancer. The resources in this section will help you learn more about neutropenia and its treatment. Sponsored by an unrestricted grant from Amgen

37. Neutropenia-Associated Infections University of Pennsylvania Medical Center Guidelines for Antibiotic Use.neutropenia AND FEVER. Clinical Setting, Recommendation, Dosage Regimen, http://www.uphs.upenn.edu/bugdrug/antibiotic_manual/neutro.htm

University of Pennsylvania Medical Center Guidelines for Antibiotic Use NEUTROPENIA AND FEVER Clinical Setting Recommendation Dosage Regimen Patient clinically stable Patient clinically unstable cefepime cefepime gentamicin 1 gm IV q 8 hour 1 gm IV q 8 hour consult dosing information at this link If fever persists without an obvious source x 72 hours or clinical deterioration occurs, consider: 1. addition of aminoglycoside (if not already receiving) 2. if perirectal infection or oral abscess, additional anaerobic coverage may be necessary consult dosing information at this link addition of amphotericin B 0.5 to 0.7 mg/kg/d IV ( more information If fever persists or patient continues to deteriorate clinically: consult Infectious Diseases Herpes Simplex Infections gingival stomatitis genital acyclovir or valacyclovir acyclovir or valacyclovir acyclovir 5 mg/kg IV q 8 hour OR valacyclovir 500mg po bid Duration 7-10 days rectal acyclovir or valacyclovir acyclovir 5 mg/kg IV q 8 hour OR valacyclovir 1gm po bid Duration 7-10 days Consider addition of vancomycin if evidence of a gram positive infection present (i.e. warmth, erythema, or tenderness at IV catheter site)

38. Neutropenia Management of Fever with neutropenia. It is not uncommon these days for cancerpatients to receive their chemotherapy in the community in which they reside. http://www.theberries.ns.ca/Archives/neutropenia.html

Management of Fever with Neutropenia It is not uncommon these days for cancer patients to receive their chemotherapy in the community in which they reside. This means of course, that those of us who treat these patients or who work in the ER will encounter the immune suppressed patient with a fever. As family physicians, we may not have much experience with this circumstance, so it's good to have ready access to guidelines for its' management.The following guidelines are used in our hospital and are the same as those used at the Izaak Walton Killam Children's Hospital in Halifax, Nova Scotia. /L. The infection rate increases gradually as the ANC falls below 0.5 x 10 /L, more sharply as it nears 0.2 x 10 /L and exponentially below 0.2 x 10 /L, it is a good idea to avoid contact with anyone having signs or symptoms of infection, as well as avoiding crowds of people. /L and the patient is in the hospital, the temperature should be taken 4-5 times a day. If the patient is at home, it should be taken if there are any signs or symptoms of infection. /L, and febrile patients with a falling ANC between 1.0 and 0.5 x 10

39. What Is Neutropenia? Content last updated on 11/11/02 with quite a bit of new information added! What Is neutropenia? . Cyndi Cramer, BA,RN,OCN. What Is neutropenia? http://www.realnurseed.com/t1000.htm

Content last updated on 11/11/02 with quite a bit of new information added! "What Is Neutropenia?" Cyndi Cramer, BA,RN,OCN R eal N urse E d.com One Contact Hour Self Learning Module Objectives: 1. Define Neutropenia. 2. Calculate an ANC and explain its significance. 3. Outline causes and risk factors for neutropenia. 4. Identify clinical consequences of neutropenia. 5. Describe management strategies for neutropenia. What Is Neutropenia? I have started a short survey of people who have read this module (whether they take the the test for credit or just read it for their own information) Click here or click the link at the bottom of the module to answer a few anonymous survey questionsTHANK YOU! When a patient’s immune system becomes compromised and is at increased risk for infection we look at more then the WBC’s (white blood cells). We actually look at the differential on the CBC and calculate the ANC (absolute neutrophil count). By doing this we are able to look at the precursors of the WBC’s. These are the "baby WBC’s" or immature blood cells. These are found in the patient’s bone marrow. This number will give us a more accurate measurement of a patient’s risk for infection. To measure this we look at the neutrophils (sometimes also called segs or polys) and the bands. The following formula is used:

40. NeLH Toolkit - Care Pathways - Pathway - Febrile Neutropenia Pathway Details Topic, Febrile neutropenia. Stage of Development, Piloting. CareSetting, Transsectoral. Pathway Title, Febrile neutropenia. Pathway summary, http://www.nelh.shef.ac.uk/nelh/kit/cps/paths.nsf/51ce819f56f7a3db80256bf4004f42

NHS Direct Online nhs.uk Department of Health Electronic Library for Social Care 31st Mar. 2003 NeLH Homepage Branch Libraries (kit based) Care Pathways Library Welcome List by title List by topic List on-line List by source List by user List by editor Search Knowledge View Pathways by.. Title Topic Available On-line Source Organisation User Organisation Editor Development Stage Jump to Topics Search Return to Welcome Back Organisational Details Organisation name Queen Mary's Hospital, Queen Mary's Sidcup NHS Trust Details Organisation Region/ Health Board England/ London Pathway Details Topic Febrile neutropenia Stage of Development Piloting Care Setting Trans-sectoral Pathway Title Febrile neutropenia Pathway summary Appraisal/ review This Record creator - organisation RCN Top (Go to ) Form: Pathways

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