Baseline Blood Work Before Initiation of Chemotherapy: What Is Safe in the Real World?

Warr, Julia; Hird, Amanda; DeAngelis, Carlo; Giotis, Angie; Ko, Yu Chieh

doi:10.1200/jop.2012.000719

Cited by 8 publications

(8 citation statements)

References 3 publications

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“…If blood work is needed to monitor side effects of therapy and response to treatment, a home‐drawn blood service can be considered, if feasible. Because of the paucity of literature available on the timing of baseline blood work before initiation of anticancer agents, the choice of accepted intervals between blood work and chemotherapy is ill defined . The HCWs can consider drawing blood work at expanded safe intervals to minimize the patient's visits to medical facilities.…”

Section: Cancer Patients In the Outpatient Settingmentioning

confidence: 99%

A Practical Approach to the Management of Cancer Patients During the Novel Coronavirus Disease 2019 (COVID-19) Pandemic: An International Collaborative Group

et al. 2020

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The outbreak of coronavirus disease 2019 (COVID‐19) has rapidly spread globally since being identified as a public health emergency of major international concern and has now been declared a pandemic by the World Health Organization (WHO). In December 2019, an outbreak of atypical pneumonia, known as COVID‐19, was identified in Wuhan, China. The newly identified zoonotic coronavirus, severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2), is characterized by rapid human‐to‐human transmission. Many cancer patients frequently visit the hospital for treatment and disease surveillance. They may be immunocompromised due to the underlying malignancy or anticancer therapy and are at higher risk of developing infections. Several factors increase the risk of infection, and cancer patients commonly have multiple risk factors. Cancer patients appear to have an estimated twofold increased risk of contracting SARS‐CoV‐2 than the general population. With the WHO declaring the novel coronavirus outbreak a pandemic, there is an urgent need to address the impact of such a pandemic on cancer patients. This include changes to resource allocation, clinical care, and the consent process during a pandemic. Currently and due to limited data, there are no international guidelines to address the management of cancer patients in any infectious pandemic. In this review, the potential challenges associated with managing cancer patients during the COVID‐19 infection pandemic will be addressed, with suggestions of some practical approaches. Implications for Practice The main management strategies for treating cancer patients during the COVID‐19 epidemic include clear communication and education about hand hygiene, infection control measures, high‐risk exposure, and the signs and symptoms of COVID‐19. Consideration of risk and benefit for active intervention in the cancer population must be individualized. Postponing elective surgery or adjuvant chemotherapy for cancer patients with low risk of progression should be considered on a case‐by‐case basis. Minimizing outpatient visits can help to mitigate exposure and possible further transmission. Telemedicine may be used to support patients to minimize number of visits and risk of exposure. More research is needed to better understand SARS‐CoV‐2 virology and epidemiology.

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Section: Cancer Patients In the Outpatient Settingmentioning

confidence: 99%

A Practical Approach to the Management of Cancer Patients During the Novel Coronavirus Disease 2019 (COVID-19) Pandemic: An International Collaborative Group

et al. 2020

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“…During this period, it is believed that nearly all the significant changes have been detected. 19 However, this interval also needs to be tested in future randomized trial.…”

Section: Discussionmentioning

confidence: 99%

Incidence and attributes of chemotherapy induced myelotoxicity, anemia and neutropenia in adults with cancer in Nepal: A cross-sectional observational study

Sah

Karn

Shah

et al. 2018

J Oncol Pharm Pract

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Background Myelosuppression remains a major toxicity in cancer patients receiving chemotherapy, and is associated with considerable morbidity, mortality and cost. Objective The present study aims to investigate the prevalence and incidence of myelotoxicity, anemia and neutropenia in the adult cancer population, and further to determine the factors influencing them. Methods This was a cross-sectional observational study conducted at National Academy of Medical Sciences, Bir Hospital, Kathmandu. A total of 170 subjects eligible for the study were enrolled for analysis. Prevalence and incidence of myelotoxicity anemia, neutropenia and myelotoxicity at enrollment and during study were investigated. Factors influencing development of myelotoxic event were determined. Results Of 170 enrolled patients, the prevalence of myelotoxicity, anemia and neutropenia at enrolment was 54 (31.8%), 20 (11.8%) and 28 (16.6%), respectively, with 27 (16%) mild and 12 (7.1%) moderate type of anemia. Incidence of myelotoxicity, anemia and neutropenia during treatment was 90 (52.94%), 44 (26%) and 53 (31.2%) respectively, with 70 (41.2%) mild, 39 (22.9%) moderate and 5 (2.9%) severe type of anemia. Age (OR: 0.49; p < 0.047), and baseline Hb (OR: 1.29; p < 0.01) were found to be independent predictors associated with anemia. Hb (OR: 2.42, CI: 1.79-3.28; p < 0.001) and smoking (OR: 0.49: p = 0.03) were found to be independent factors associated myelotoxicity. Conclusion Our study confirmed a high incidence rate of myelotoxicity, neutropenia and anemia in a considerable number of Nepalese cancer patients receiving chemotherapy, and that baseline Hb, smoker and older adults are at more risk, these patients should be evaluated carefully and a prophylactic measure should be adopted accordingly so as to prevent toxicity and improve quality of life during cancer treatment.

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“…The mechanism of renal and hepatic toxicity with anti-cancer agents is beyond the scope of this article, but several reviews cover this topic in depth. 18,[28][29][30][31][32][33] Additional organ and lab monitoring. While renal and hepatic functioning are most broadly assessed, depending on the patient and regimen pharmacists may need to evaluate additional organ systems and labs prior to approving treatment.…”

Section: Organ Function and Labsmentioning

confidence: 99%

“…The mechanism of renal and hepatic toxicity with anti-cancer agents is beyond the scope of this article, but several reviews cover this topic in depth. 18,28–33…”

Section: Pronto: a Checklistmentioning

confidence: 99%

“…A retrospective trial suggested that labs within seven days of treatment are accurate in the majority of cases. 29 If labs are outside the stated treatment conditions or recent labs are not available, the provider should be contacted. While we have provided some highlights of laboratory monitoring, the interested reader can find a more thorough treatment of the topic in a previously published review.…”

Section: Pronto: a Checklistmentioning

confidence: 99%

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Start using a checklist, PRONTO: Recommendation for a standard review process for chemotherapy orders

crandell

Bates

Grgic

2017

J Oncol Pharm Pract

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Chemotherapy order review by pharmacists requires careful attention to many details, and serious consequences can occur if errors are made. Other high-risk industries have long used checklists to improve accuracy and reduce the risk of errors. Despite the recent expansion of checklist use in other areas of medicine, there is currently no published evidence that checklists are being widely used by pharmacists in the evaluation of chemotherapy orders. This article explains a flexible checklist called PRONTO (Patient, Regimen, Organ Function, Numbers, Toxicity, Order Verification) that has been successfully used by pharmacists in variety of practice settings in two academic centers in North Carolina. Proposed benefits of using a checklist in order review include standardization of review for better communication between collaborating pharmacists, a training tool for new or cross-training pharmacists, and an educational tool for students.

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Baseline Blood Work Before Initiation of Chemotherapy: What Is Safe in the Real World?

Abstract: Adherence to the institutional recommendation of BBW within 6 weeks was high. Baseline laboratory tests performed within 7 days of chemotherapy initiation would have detected nearly all significant changes; therefore, we suggest that this interval be tested in future randomized trials.

Cited by 8 publications

References 3 publications

A Practical Approach to the Management of Cancer Patients During the Novel Coronavirus Disease 2019 (COVID-19) Pandemic: An International Collaborative Group

A Practical Approach to the Management of Cancer Patients During the Novel Coronavirus Disease 2019 (COVID-19) Pandemic: An International Collaborative Group

Incidence and attributes of chemotherapy induced myelotoxicity, anemia and neutropenia in adults with cancer in Nepal: A cross-sectional observational study

Start using a checklist, PRONTO: Recommendation for a standard review process for chemotherapy orders

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