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> Disorders > Disease or Syndrome > Neutropenia

Neutropenia

Neutropenia is a condition characterized by an abnormally low number of neutrophils, a type of white blood cell crucial for fighting infections.
Individuals with Neutropenia are at increased risk of developing serious bacterial and fungal infections.
This condition can be caused by various factors, including chemotherapy, autoimmune disorders, or genetic factors.
Accurate diagnosis and management of Neutropenia are essential to prevent life-threatening complications.
PubCompare.ai's AI-powered platform can assist researchers in optimizing Neutropenia studies by identifying the most relevant protocols from literature, preprints, and patents, while providing accurate comparisons to identify the best approaches.
This can enhance reproducibility and accuaracy in Neutropenia research, ultimately leading to improved patient outcomes.

Most cited protocols related to «Neutropenia»

1
Cryptococcal Meningitis Treatment Regimens
Between July 2007 and May 2010 sequential HIV-positive adults (age ≥ 21 years) with a first episode of cryptococcal meningitis, diagnosed by CSF India ink or cryptococcal antigen testing (titres ≥ 1:1024, Meridian Cryptococcal Latex Agglutination System, Meridian Bioscience) were screened for enrollment. Exclusion criteria were an alanine aminotransferase concentration more than five times the upper limit of normal (> 200 IU/ml), a neutrophil count < 500 × 106 cells/L, a platelet count < 50,000 × 106 cells/L, pregnancy or lactation, previous serious reaction to study drugs or concomitant medication contraindicated with study drugs. Patients already receiving ART were also excluded. Written informed consent was obtained from each participant, or from the next of kin for patients with altered mental status, prior to randomization. Randomisation was stratified by Glasgow Coma Score (GCS) of 15 or <15. Patients were assigned to one of three intervention groups by means of random computer generated lists in block sizes of 8, using numbers in two sets of sealed envelopes (GCS of 15 or <15) prepared by independent persons. Study clinicians opened envelopes in sequence from the appropriate set as patients were enrolled.
The three intervention arms were: (1) Amphotericin B deoxycholate (Fungizone, Bristol-Myers Squibb) 1mg/kg/day by intravenous infusion over 4 hours plus oral flucytosine (Valeant pharmaceuticals) 25mg/kg 4 times per day for 2 weeks (“Standard therapy”), (2) Standard therapy plus Interferon-γ1b (Immukin, Boehringer Ingelheim) 100μg by sub-cutaneous injection on days 1 and 3 (“IFNγ 2-doses”), and (3) Standard therapy plus Interferon-γ1b (Immukin, Boehringer Ingelheim) 100μg by sub-cutaneous injection on days 1, 3, 5, 8, 10 and 12 (“IFNγ 6-doses”).
Unless contraindicated all patients received 1L 0.9% (normal) saline with 20mmol KCl prior to amphotericin B to minimise nephrotoxicity, and were routinely given oral potassium and magnesium supplementation. Amphotericin B was discontinued if the serum creatinine increased to >220μmol/L despite adequate hydration, and patients were switched to fluconazole 400mg/day. When necessary, flucytosine doses were adjusted for reduced renal function, reduced by 50% for grade 3 neutropaenia or thrombocytopaenia, and discontinued for grade 4 neutropaenia or thrombocytopaenia. After 2 weeks all patients received fluconazole (Diflucan, Pfizer) 400mg daily for 8 weeks and 200mg daily thereafter, unless they were taking rifampicin, in which case doses were increased by 50%. Anti-retroviral therapy with stavudine, lamivudine and either efavirenz or nevirapine was initiated between 2 and 4 weeks after starting antifungal therapy, unless contra-indicated, in accordance with South African national guidelines [18 , 19 ], and patients were followed-up for one-year post enrolment with particular attention paid to any clinical presentations related to cryptococcal immune reconstitution inflammatory syndrome (IRIS).
Jarvis J.N., Meintjes G., Rebe K., Williams G.N., Bicanic T., Williams A., Schutz C., Bekker L.G., Wood R, & Harrison T.S. (2012). Adjunctive Interferon-γ Immunotherapy for the Treatment of HIV-associated Cryptococcal Meningitis: A Randomized Controlled Trial.. AIDS (London, England), 26(9), 1105-1113.
Publication 2012
Adult Amphotericin B amphotericin B, deoxycholate drug combination Antifungal Agents Antigens Arm, Upper Attention Breast Feeding Comatose Creatinine Cryptococcus D-Alanine Transaminase Diflucan efavirenz Fluconazole Flucytosine Fungizone HIV Seropositivity Immune Reconstitution Inflammatory Syndrome India ink interferon gamma-1b Interferon Type II Intravenous Infusion Iris Kidney Lamivudine Latex Fixation Tests L Cells Magnesium Meningitis, Cryptococcal Mentally Ill Persons Meridians Neutropenia Neutrophil Nevirapine Normal Saline Patients Pharmaceutical Preparations Phocidae Platelet Counts, Blood Potassium Pregnancy Retroviridae Rifampin Serum Southern African People Stavudine Therapeutics Thrombocytopenia
2
Cost Analysis of First-Line and Second-Line NSCLC Treatments
We considered the costs of first-line and subsequent treatment, treating adverse events (AEs), and general treatment associated with disease management including routine follow-up, BSC, and end-of-life care. In the first-line and subsequent second-line treatments, the price of camrelizumab, pembrolizumab, and nivolumab were sourced from the big data service platform for China’s health industry (https://www.yaozh.com/) (The big data service platform for China’s health industry, 2021 ). According to the cancer immunotherapy patient assistance program in China, NSCLC patients could avail up to 2 years of assistance after purchasing four cycles of pembrolizumab. In terms of this, four cycle’s cost of pembrolizumab was considered in our model. In calculating dosage amounts, we used a mean body weight of 65 kg and a mean body surface area of 1.72 m2 for base case patients (Liu et al., 2020b (link)). In the context of the universal medical insurance systems, essential drugs such as carboplatin, folic acid, and vitamin B12 have been fully covered by the National Reimbursement Drug List (NRDL), and the proportion of patient’s out-of-pocket expenses for these drugs is 0%. Therefore, the costs of these drugs were excluded from this analysis. Besides, pemetrexed and docetaxel have been included in the NRDL, with a reimbursement proportion of 80 and 95%, respectively.
In addition, to better reflect the cost of first-line and second-line treatments in real-world settings, the duration of these treatments were adjusted based on the median treatment cycles reported in the respective clinical trials (Gandhi et al., 2018 (link); Wu et al., 2019 (link); Zhou et al., 2021b (link)), to account for the fact that patients may discontinue first-line and second-line treatments due to unacceptable toxicity, consent withdrawal, or investigator decision, in addition to progression and death. The cost of subsequent third-line therapy, routine follow-up, BSC, and end-of-life care came from a published study (Liu et al., 2020b (link)).
The cost of commonly reported grade III/IV AEs with an incidence of >5% were incorporated in the model, including neutropenia, thrombocytopenia, and anemia (Gandhi et al., 2018 (link); Zhou et al., 2021b (link)). Although some common immune-related AEs related to camrelizumab were reported, such as reactive capillary endothelial proliferation and immune-related pneumonitis, their costs were not considered in this model because of their low grade III/IV incidence. The costs per patient corresponding to each AE were sourced from published literature (Supplement Table S4) (Gu et al., 2019 (link); You et al., 2019 (link)). Cost inputs are detailed in Table 1.
Qiao L., Zhou Z., Zeng X, & Tan C. (2021). Cost-Effectiveness of Domestic PD-1 Inhibitor Camrelizumab Combined With Chemotherapy in the First-Line Treatment of Advanced Nonsquamous Non–Small-Cell Lung Cancer in China. Frontiers in Pharmacology, 12, 728440.
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Publication 2021
Anemia Body Surface Area Body Weight camrelizumab Capillary Endothelium Carboplatin Cobalamins Dietary Supplements Disease Management Disease Progression Docetaxel Drugs, Essential Folic Acid Hospice Care Immunotherapy Malignant Neoplasms Neutropenia Nivolumab Non-Small Cell Lung Carcinoma Patients pembrolizumab Pharmaceutical Preparations Pneumonitis Therapeutics Thrombocytopenia
3
Vemurafenib versus Dacarbazine for Metastatic Melanoma
From January 2010 through December 2010, a total of 2107 patients underwent screening at 104 centers in 12 countries worldwide. The most common reason for screening failure was a negative test for the BRAF V600 mutation. A total of 675 patients were randomly assigned in a 1:1 ratio to receive either vemurafenib (at a dose of 960 mg twice daily orally) or dacarbazine (at a dose of 1000 mg per square meter of body-surface area by intravenous infusion every 3 weeks) (Fig. A in the Supplementary Appendix, available with the full text of this article at NEJM.org). These patients included 20 with non-V600E mutations (19 with V600K and 1 with V600D), as identified on Sanger and 454 sequencing. Baseline characteristics of the patients were well balanced (Table 1).
Study patients were stratified according to American Joint Committee on Cancer stage (IIIC, M1a, M1b, or M1c), ECOG performance status (0 or 1), geographic region (North America, Western Europe, Australia or New Zealand, or other region), and serum lactate dehydrogenase level (normal or elevated).
Dose reductions for both vemurafenib and dacarbazine were prespecified for intolerable grade 2 toxic effects or worse. The development of cutaneous squamous-cell carcinoma did not require dose modification. The administration of vemurafenib was interrupted until the resolution of the toxic effect to at least grade 1 and restarted at 720 mg twice daily (480 mg twice daily for grade 4 events), with a dose reduction to 480 mg twice daily if the toxic effects recurred. If the toxic effect did not improve to grade 1 or lower or recurred at the 480-mg twice-daily dose, treatment was discontinued permanently. The administration of dacarbazine was interrupted for grade 3 or 4 toxic effects and could be restarted on recovery within 1 week to grade 1 (at full dose) or grade 2 (at 75% dose) or at 75% dose for grade 4 neutropenia or febrile neutropenia. A second dose reduction was allowed, if needed. Antiemetics and granulocyte colony-stimulating factor were administered according to standards at each study center. Treatment was discontinued on disease progression unless continued treatment was in the best interest of the patient in the judgment of the investigator and the sponsor.
Chapman P.B., Hauschild A., Robert C., Haanen J.B., Ascierto P., Larkin J., Dummer R., Garbe C., Testori A., Maio M., Hogg D., Lorigan P., Lebbe C., Jouary T., Schadendorf D., Ribas A., O’Day S.J., Sosman J.A., Kirkwood J.M., Eggermont A.M., Dreno B., Nolop K., Li J., Nelson B., Hou J., Lee R.J., Flaherty K.T, & McArthur G.A. (2011). Improved Survival with Vemurafenib in Melanoma with BRAF V600E Mutation. The New England journal of medicine, 364(26), 2507-2516.
Publication 2011
Antiemetics BAD protein, human Body Surface Area BRAF protein, human Cancer of Skin Dacarbazine Disease Progression Drug Tapering Electrocorticography Febrile Neutropenia Granulocyte Colony-Stimulating Factor Intravenous Infusion Joints Lactate Dehydrogenase Mutation Neutropenia Patients Serum Squamous Epithelial Cells Staging, Cancer Vemurafenib
4
Genetic Variants in Schizophrenia Discovery
‘The discovery sample’ consisted of 7129 schizophrenic cases (prior to quality control (QC) filtering) from the CLOZUK (N = 6558) and the CardiffCOGS (N = 571) samples, which have been previously described (6 ,15 ,35 (link)) but have not yet contributed to any analysis aimed at identifying new CNV loci. Briefly, the CLOZUK sample consists of patients taking the antipsychotic clozapine, a drug reserved in the UK for patients that have not responded to trials of at least two other antipsychotics. To allow for early detection of neutropaenia that can result from treatment with clozapine, patients are required to provide regular blood samples. Through collaboration with Novartis, the manufacturer of a proprietary form of clozapine (Clozaril), we acquired anonymized DNA samples from people with schizophrenia who were taking the drug. Approval by the local ethics committee was granted for the use of these samples in genetic association studies. Patients are aged 18–90, had a recorded diagnosis of treatment resistant schizophrenia, and 71% are male. A higher male ratio is not unusual for samples recruited for genetic studies in schizophrenia: this proportion is 66% in the ISC study (2 (link)) and 70% in the MGS study (4 (link)). The CardiffCOGS is a sample of clinically diagnosed schizophrenia patients from the UK. Interview with the SCAN instrument (36 (link)) and case note review was used to arrive at a best-estimate lifetime diagnosis according to DSM-IV criteria (37 ). All discovery cases were genotyped at the Broad Institute, Stanley Centre for Psychiatric Research, USA on either Illumina OmniExpress or OmniCombo arrays.
The discovery control cohort consisted of four publicly available, non-psychiatric datasets, totaling 12 080 samples prior to QC (Supplementary Material, Table S2). These datasets were chosen as they were genotyped on Illumina arrays similar to those used for the cases: Illumina Human Omni2.5, Illumina HumanOmni1_Quad or Illumina 1.2M. Further details of these samples are provided in the Supplementary Material.
Rees E., Walters J.T., Chambert K.D., O'Dushlaine C., Szatkiewicz J., Richards A.L., Georgieva L., Mahoney-Davies G., Legge S.E., Moran J.L., Genovese G., Levinson D., Morris D.W., Cormican P., Kendler K.S., O'Neill F.A., Riley B., Gill M., Corvin A., Sklar P., Hultman C., Pato C., Pato M., Sullivan P.F., Gejman P.V., McCarroll S.A., O'Donovan M.C., Owen M.J, & Kirov G. (2013). CNV analysis in a large schizophrenia sample implicates deletions at 16p12.1 and SLC1A1 and duplications at 1p36.33 and CGNL1. Human Molecular Genetics, 23(6), 1669-1676.
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Publication 2013
Antipsychotic Agents BLOOD Clozapine Diagnosis Early Diagnosis Genetic Association Studies Homo sapiens Males Neutropenia Patients Pharmaceutical Preparations Radionuclide Imaging Regional Ethics Committees Schizophrenia Schizophrenia, Treatment-Resistant Strains
5
Cabazitaxel Safety and Efficacy Evaluation
The target sample size was planned to be 500 patients for comprehensive evaluation of the safety profile of cabazitaxel. This sample size was deemed sufficient based on the incidence rates of the priority survey items that exceeded 1.0% in the Japanese Phase I study (14 (link)) and in the international Phase III studies (12 (link),22 (link)).
Data from all patients who received at least one dose of cabazitaxel were included in the safety evaluation.
Baseline patient characteristics were summarized descriptively in terms of the mean ± standard deviation, median (range), or number (percent) of patients. The frequencies of ADRs were also analyzed descriptively in terms of the number (percent) of patients. For efficacy, the PSA response rate was summarized as the number (percent) of patients showing a PSA response of ≥50% or ≥30% from each of the two baseline levels (≥20 and ≥5 ng/ml). Median OS and TTF with 95% confidence intervals (CI) were estimated using the Kaplan–Meier method.
The proportions of patients who experienced neutropenia or febrile neutropenia were compared between those who received prophylactic G-CSF and those who did not using Fisher’s exact test. No other statistical comparisons were made.
Suzuki K., Matsubara N., Kazama H., Seto T., Tsukube S, & Matsuyama H. (2019). Safety and efficacy of cabazitaxel in 660 patients with metastatic castration-resistant prostate cancer in real-world settings: results of a Japanese post-marketing surveillance study. Japanese Journal of Clinical Oncology, 49(12), 1157-1163.
Publication 2019
cabazitaxel Condoms Drug Reaction, Adverse Febrile Neutropenia Granulocyte Colony-Stimulating Factor Japanese Neutropenia Patients Patient Safety Safety

Most recents protocols related to «Neutropenia»

1
Nivolumab, Cisplatin, and Paclitaxel/5-FU Combination
A fixed dose of 360 mg nivolumab will be administered intravenously on day 1, followed by cisplatin (80 mg/m2) and paclitaxel (175 mg/m2) on day 2, or cisplatin (80 mg/m2) on day 2 and 5-fluorouracil (800 mg/m2) on days 2–6, every 3 weeks (2 cycles). All given intravenously.
Dosage adjustment is not permitted for nivolumab, but are allowed for chemotherapy in case of severe febrile neutropenia or neutropenia, thrombocytopenia and anemia. Treatment will be interrupted or postponed in case of any serious AE (SAE), and could be resumed until the protocol-defined criteria for treatment resumption is met.
Yin J., Lin S., Fang Y., Jiao H., Chen Z., Tang H., Gu J., Zhang S., Sun L., Li Y., Han Y., Chen Q., Chen H., Li Z, & Tan L. (2023). Neoadjuvant therapy with immunoagent (nivolumab) or placebo plus chemotherapy followed by surgery and adjuvant treatment in subjects with resectable esophageal squamous cell carcinoma: study protocol of a randomized, multicenter, double blind, phase II trial (NATION-2203 trial). Journal of Thoracic Disease, 15(2), 718-730.
Publication 2023
Anemia Cisplatin Febrile Neutropenia Fluorouracil Neutropenia Nivolumab Paclitaxel Pharmacotherapy Thrombocytopenia
2
Radium-223 for Metastatic Castration-Resistant Prostate Cancer
Figure 1 gives an overview of the procedures that patients will undergo during the study. In both study groups, all active metastases will be treated with stereotactic body radiation therapy or intensity-modulated radiation therapy for local control. All patients will then receive six 120-mg doses of subcutaneously injected denosumab every four weeks as the best standard of care (BSoC) for CRPC patients with bone metastasis. The control group will receive BSoC only, while the radium-223 group will also receive a maximum of six doses of the study's research drug, radium-223; Xofigo® (Bayer Inc.), intravenously at 55 kBa/kg every four weeks, starting within two weeks after the completion of radiotherapy for active metastases. No placebo will be used in this study.

Design of the MEDAL trial

If an adverse reaction occurs due to radium-223 administration, the degree of the adverse reaction should be evaluated according to Common Terminology Criteria for Adverse Events (CTCAE) version 5.0, and the dose should be withdrawn or reduced. In case of grade 3 or higher neutropenia, anemia, or thrombocytopenia, administration should be postponed until recovery to grade 2 or lower, and then resumed after confirmation of recovery. If the grade of neutropenia or thrombocytopenia does not recover to grade 2 or below within 6 weeks of the last dose, administration should be discontinued. For grade 3 or higher diarrhea, nausea, vomiting, or constipation, postpone administration until recovery to grade 2 or lower, and resume administration after confirming recovery. If grade 4 events persist for more than 7 days, administration should be discontinued.
Yoshida S., Takahara T., Arita Y., Ito M., Hayakawa S., Oguchi T., Komai Y., Numao N., Yuasa T., Inoue M., Ushijima H., Kudo S., Shimano Y., Nakamura Y., Uchida Y., Uehara S., Tanaka H., Yaegashi H., Izumi K., Yokoyama M., Matsuoka Y., Yoshioka Y., Konishi K., Nakanishi K., Nagahara A., Hirakawa A., Koike R., Koga F., Nishimura K., Mizokami A., Yonese J., Kageyama Y., Yoshimura R, & Fujii Y. (2023). A phase II randomized trial of metastasis-directed therapy with alpha emitter radium-223 in men with oligometastatic castration-resistant prostate cancer (MEDAL). BMC Urology, 23, 33.
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Publication 2023
Anemia Bones Constipation Denosumab Diarrhea Human Body Nausea Neoplasm Metastasis Neutropenia Patients Placebos Radiosurgery, Stereotactic Radiotherapy Radiotherapy, Intensity-Modulated Radium-223 Thrombocytopenia Xofigo
3
Kidney Transplant Immunosuppression Protocol
Before the administration of ATG (1.5 mg/kg/day intravenously), chlorpheniramine and acetaminophen were given intravenously as a premedication. The dose of ATG was reduced by 50% in patients with thrombocytopenia (platelet count 50,000–75,000 per cubic millimeter) or neutropenia (absolute neutrophil count 2000–3000 per cubic millimeter). ATG was discontinued when the patiet developed severe thrombocytopenia (platelet count < 50,000 per cubic millimeter) or severe neutropenia (absolute neutrophil count < 2000 per cubic millimeter).
The maintenance immunosuppressants consisted of tacrolimus, mycophenolate mofetil, and seven-day methylprednisolone taper. Tacrolimus was initiated two days before kidney transplantation at a dose of 0.05 mg/kg twice a day, and the target trough level was 6–8ng/ml until one year post-transplant. Mycophenolate mofetil was given 750 mg twice a day in both groups. Methylprednisolone was administered at a dose of 500 mg intravenously on day 0, 250 mg on day 1, and 125 mg on day 2 and 3. Thereafter, a fast taper was carried out with oral prednisone in the first week post-transplant.
All recipients received oral doses of trimethoprim 80 mg-sulfamethoxazole 400 mg daily for six months for bacterial and Pneumocystis jiroveci prophylaxis. Valganciclovir was administered for cytomegalovirus (CMV) prophylaxis for six months when a seronegative recipient had kidney transplantation from a seropositive donor. For low-to-intermediate risk patients, CMV monitoring was performed on a weekly basis using CMV-PCR assay for preemptive treatment. If the viral load of CMV was more than 4.0 log in the CMV-PCR assay, intravenous ganciclovir or oral valganciclovir was administered until CMV viremia was eliminated. In addition, BKV-PCR assay was also done on a monthly basis for BKV monitoring.
Ko Y., Wee Y.M., Shin S., Kim M.J., Choi M.Y., Kim D.H., Lim S.J., Jung J.H., Kwon H., Kim Y.H, & Han D.J. (2023). A prospective, randomized, non-blinded, non-inferiority pilot study to assess the effect of low-dose anti-thymocyte globulin with low-dose tacrolimus and early steroid withdrawal on clinical outcomes in non-sensitized living-donor kidney recipients. PLOS ONE, 18(3), e0280924.
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Publication 2023
Acetaminophen Bacteria Biological Assay Chlorpheniramine Cuboid Bone Cytomegalovirus Donors Ganciclovir Grafts Immunosuppressive Agents Kidney Transplantation Methylprednisolone Mycophenolate Mofetil Neutropenia Neutrophil Patients Platelet Counts, Blood Pneumocystis jiroveci Prednisone Premedication Tacrolimus Thrombocytopenia Trimethoprim-Sulfamethoxazole Combination Valganciclovir Viremia
4
Genetic Variations and Adverse Outcomes in ALL

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Publication 2023
Diagnosis Genetic Diversity Mutation Neutropenia Patients Therapeutics
5
Economic Evaluation of Lung Cancer Treatments
Health resource use and only direct medical expenditures were regarded, including those related to drug acquisition and administration, disease management, and treatment-related adverse events (AEs) (Table 1).
Acquisition costs for toripalimab, carboplatin, nab-paclitaxel, pemetrexed, and subsequent treatments were obtained from public databases, which were all the latest in 2022 (Shao et al., 2022 (link); YAOZH.com, 2022 ). The cost of drug management was equal to the cost of the chemotherapy drug preparation injection plus the cost of hospitalization. According to the published literature, the one-time cost of end-of-life care per patient who died was $2,241.18 (Rui et al., 2022 (link)), best supportivecare cost per cycle was $122.18 (Li et al., 2020 (link)). We only regarded severe AEs (grade ≥3) with an incidence of greater than 5%, involving anemia, neutropenia, leukopenia, and thrombocytopenia (Wang et al., 2022 (link)). The AEs costs were extracted from published articles (Yang et al., 2021 (link)). For each therapeutic regimen, the total expenditure per AE was calculated based on the incidence of AE and its related unit cost. It is assumed that after the occurrence of AEs, patients are treated only in the first cycle, and the cost of AE occurs only once. Drug dosage was calculated according to a body surface area of 1.72 m2 and creatinine clearance of 70 mL/min (Goulart and Ramsey, 2011 (link); Wu et al., 2011 (link)). Suppose that the corresponding expense is incurred at the beginning of each cycle; thus, there is no cost adjustment for the half cycle (Chen et al., 2022 (link)). From January to September 2022, the exchange rate of Chinese Yuan renminbi was 6.6 yuan per US dollar average. Total costs and quality-adjusted life-years (QALYs) were the primary outcomes, and a 5% discount rate per year was adopted in our analysis (Yang et al., 2021 (link)).
Huo G., Liu W., Kang S, & Chen P. (2023). Toripalimab plus chemotherapy vs. chemotherapy in patients with advanced non-small-cell lung cancer: A cost-effectiveness analysis. Frontiers in Pharmacology, 14, 1131219.
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Publication 2023
130-nm albumin-bound paclitaxel Anemia Body Surface Area Carboplatin Chinese Creatinine Drug Compounding Hospice Care Hospitalization Leukopenia Neutropenia Patients Pharmaceutical Preparations Pharmacotherapy Therapeutics Thrombocytopenia toripalimab Treatment Protocols

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