Skip to main content
Erschienen in: best practice onkologie 6/2022

20.06.2022 | Zytostatische Therapie | CME-Topic

G-CSF zur Prophylaxe der Neutropenie und der febrilen Neutropenie, Anämie bei Krebserkrankung

Supportivtherapieleitlinien, Teil 1

verfasst von: Hartmut Link

Erschienen in: best practice onkologie | Ausgabe 6/2022

Einloggen, um Zugang zu erhalten

Zusammenfassung

Infektionen bei neutropenischen Patienten nach Chemotherapie manifestieren sich meistens durch Fieber (febrile Neutropenie, FN). Zu den wichtigsten Determinanten des FN-Risikos gehören der Chemotherapietyp, die Dosisintensität und patientenspezifische Faktoren. Bei einem FN-Risiko von 20 % oder höher wird die Granulopoese nach der Therapie prophylaktisch mit G‑CSF („granulocyte colony-stimulating factor“) stimuliert. Eine Anämie sollte immer abgeklärt und falls erforderlich entsprechend ihrer Ursache bei Anämiebeschwerden behandelt werden. Wenn ein absoluter oder funktioneller Eisenmangel vorliegt, dann ist meistens eine intravenöse (i.v.) Eisensubstitution erforderlich. Erythropoesestimulierende Substanzen können nach Chemotherapie bei Hämoglobin(Hb)-Werten unter 10 g/dl (6,2 mmol/l) verwendet werden. Bei chronischer Anämie und Hb-Werten unter 8–7 g/dl (< 5,0–4,3 mmol/l) sollte die Indikation für die Transfusion von Erythrozytenkonzentraten primär anhand der individuellen klinischen Symptomatik gestellt werden.
Literatur
1.
Zurück zum Zitat Gabrilove JL, Jakubowski A, Scher H, Sternberg C, Wong G, Grous J et al (1988) Effect of granulocyte colony-stimulating factor on neutropenia and associated morbidity due to chemotherapy for transitional-cell carcinoma of the urothelium. N Engl J Med 318:1414–1422CrossRef Gabrilove JL, Jakubowski A, Scher H, Sternberg C, Wong G, Grous J et al (1988) Effect of granulocyte colony-stimulating factor on neutropenia and associated morbidity due to chemotherapy for transitional-cell carcinoma of the urothelium. N Engl J Med 318:1414–1422CrossRef
3.
Zurück zum Zitat Heinz WJ, Buchheidt D, Christopeit M, von Lilienfeld-Toal M, Cornely OA, Einsele H et al (2017) Diagnosis and empirical treatment of fever of unknown origin (FUO) in adult neutropenic patients: guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO). Ann Hematol 96(11):1775–1792. https://doi.org/10.1007/s00277-017-3098-3CrossRefPubMedPubMedCentral Heinz WJ, Buchheidt D, Christopeit M, von Lilienfeld-Toal M, Cornely OA, Einsele H et al (2017) Diagnosis and empirical treatment of fever of unknown origin (FUO) in adult neutropenic patients: guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO). Ann Hematol 96(11):1775–1792. https://​doi.​org/​10.​1007/​s00277-017-3098-3CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Sternberg CN, Mulder PH, Schornagel JH, Théodore C, Fossa SD, Oosterom ATv et al (2001) Randomized phase III trial of high–dose-intensity methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) chemotherapy and recombinant human granulocyte colony-stimulating factor versus classic MVAC in advanced urothelial tract tumors: European organization for research and treatment of cancer protocol no. 30924. J Clin Oncol 19(10):2638–2646. https://doi.org/10.1200/jco.2001.19.10.2638CrossRefPubMed Sternberg CN, Mulder PH, Schornagel JH, Théodore C, Fossa SD, Oosterom ATv et al (2001) Randomized phase III trial of high–dose-intensity methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) chemotherapy and recombinant human granulocyte colony-stimulating factor versus classic MVAC in advanced urothelial tract tumors: European organization for research and treatment of cancer protocol no. 30924. J Clin Oncol 19(10):2638–2646. https://​doi.​org/​10.​1200/​jco.​2001.​19.​10.​2638CrossRefPubMed
6.
Zurück zum Zitat Sternberg CN, Skoneczna I, Kerst JM, Albers P, Fossa SD, Agerbaek M et al (2015) Immediate versus deferred chemotherapy after radical cystectomy in patients with pT3-pT4 or N+ M0 urothelial carcinoma of the bladder (EORTC 30994): an intergroup, open-label, randomised phase 3 trial. Lancet Oncol 16(1):76–86. https://doi.org/10.1016/s1470-2045(14)71160-xCrossRefPubMed Sternberg CN, Skoneczna I, Kerst JM, Albers P, Fossa SD, Agerbaek M et al (2015) Immediate versus deferred chemotherapy after radical cystectomy in patients with pT3-pT4 or N+ M0 urothelial carcinoma of the bladder (EORTC 30994): an intergroup, open-label, randomised phase 3 trial. Lancet Oncol 16(1):76–86. https://​doi.​org/​10.​1016/​s1470-2045(14)71160-xCrossRefPubMed
7.
Zurück zum Zitat Pfister C, Gravis G, Fléchon A, Chevreau C, Mahammedi H, Laguerre B et al (2022) Dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin or gemcitabine and cisplatin as perioperative chemotherapy for patients with nonmetastatic muscle-invasive bladder cancer: results of the GETUG-AFU V05 VESPER trial. J Clin Oncol. https://doi.org/10.1200/jco.21.02051CrossRefPubMed Pfister C, Gravis G, Fléchon A, Chevreau C, Mahammedi H, Laguerre B et al (2022) Dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin or gemcitabine and cisplatin as perioperative chemotherapy for patients with nonmetastatic muscle-invasive bladder cancer: results of the GETUG-AFU V05 VESPER trial. J Clin Oncol. https://​doi.​org/​10.​1200/​jco.​21.​02051CrossRefPubMed
8.
Zurück zum Zitat Bellmunt , von der Maase H, Mead GM, Skoneczna I, De Santis M, Daugaard G et al (2012) Randomized phase III study comparing paclitaxel/cisplatin/gemcitabine and gemcitabine/cisplatin in patients with locally advanced or metastatic urothelial cancer without prior systemic therapy: EORTC Intergroup Study 30987. J Clin Oncol 30(10):1107–1113. https://doi.org/10.1200/jco.2011.38.6979CrossRefPubMedPubMedCentral Bellmunt , von der Maase H, Mead GM, Skoneczna I, De Santis M, Daugaard G et al (2012) Randomized phase III study comparing paclitaxel/cisplatin/gemcitabine and gemcitabine/cisplatin in patients with locally advanced or metastatic urothelial cancer without prior systemic therapy: EORTC Intergroup Study 30987. J Clin Oncol 30(10):1107–1113. https://​doi.​org/​10.​1200/​jco.​2011.​38.​6979CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat von der Maase H, Hansen SW, Roberts JT, Dogliotti L, Oliver T, Moore MJ et al (2000) Gemcitabine and cisplatin versus methotrexate, vinblastine, doxorubicin, and cisplatin in advanced or metastatic bladder cancer: results of a large, randomized, multinational, multicenter, phase III study. J Clin Oncol 18(17):3068–3077. https://doi.org/10.1200/jco.2000.18.17.3068CrossRefPubMed von der Maase H, Hansen SW, Roberts JT, Dogliotti L, Oliver T, Moore MJ et al (2000) Gemcitabine and cisplatin versus methotrexate, vinblastine, doxorubicin, and cisplatin in advanced or metastatic bladder cancer: results of a large, randomized, multinational, multicenter, phase III study. J Clin Oncol 18(17):3068–3077. https://​doi.​org/​10.​1200/​jco.​2000.​18.​17.​3068CrossRefPubMed
12.
Zurück zum Zitat Eisenberger M, Hardy-Bessard AC, Kim CS, Géczi L, Ford D, Mourey L et al (2017) Phase III study comparing a reduced dose of cabazitaxel (20 mg/m(2)) and the currently approved dose (25 mg/m(2)) in postdocetaxel patients with metastatic castration-resistant prostate cancer-PROSELICA. J Clin Oncol 35(28):3198–3206. https://doi.org/10.1200/jco.2016.72.1076CrossRefPubMed Eisenberger M, Hardy-Bessard AC, Kim CS, Géczi L, Ford D, Mourey L et al (2017) Phase III study comparing a reduced dose of cabazitaxel (20 mg/m(2)) and the currently approved dose (25 mg/m(2)) in postdocetaxel patients with metastatic castration-resistant prostate cancer-PROSELICA. J Clin Oncol 35(28):3198–3206. https://​doi.​org/​10.​1200/​jco.​2016.​72.​1076CrossRefPubMed
14.
15.
Zurück zum Zitat de Wit R, Stoter G, Sleijfer DT, Neijt JP, ten Bokkel Huinink WW, de Prijck L et al (1998) Four cycles of BEP vs four cycles of VIP in patients with intermediate-prognosis metastatic testicular non-seminoma: a randomized study of the EORTC Genitourinary Tract Cancer Cooperative Group. European Organization for Research and Treatment of Cancer. Br J Cancer 78(6):828–832. https://doi.org/10.1038/bjc.1998.587CrossRefPubMedPubMedCentral de Wit R, Stoter G, Sleijfer DT, Neijt JP, ten Bokkel Huinink WW, de Prijck L et al (1998) Four cycles of BEP vs four cycles of VIP in patients with intermediate-prognosis metastatic testicular non-seminoma: a randomized study of the EORTC Genitourinary Tract Cancer Cooperative Group. European Organization for Research and Treatment of Cancer. Br J Cancer 78(6):828–832. https://​doi.​org/​10.​1038/​bjc.​1998.​587CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat de Wit R, Roberts JT, Wilkinson PM, de Mulder PH, Mead GM, Fosså SD et al (2001) Equivalence of three or four cycles of bleomycin, etoposide, and cisplatin chemotherapy and of a 3- or 5‑day schedule in good-prognosis germ cell cancer: a randomized study of the European Organization for Research and Treatment of Cancer Genitourinary Tract Cancer Cooperative Group and the Medical Research Council. J Clin Oncol 19(6):1629–1640. https://doi.org/10.1200/jco.2001.19.6.1629CrossRefPubMed de Wit R, Roberts JT, Wilkinson PM, de Mulder PH, Mead GM, Fosså SD et al (2001) Equivalence of three or four cycles of bleomycin, etoposide, and cisplatin chemotherapy and of a 3- or 5‑day schedule in good-prognosis germ cell cancer: a randomized study of the European Organization for Research and Treatment of Cancer Genitourinary Tract Cancer Cooperative Group and the Medical Research Council. J Clin Oncol 19(6):1629–1640. https://​doi.​org/​10.​1200/​jco.​2001.​19.​6.​1629CrossRefPubMed
18.
Zurück zum Zitat Bayraktar S, Gonzalez-Angulo AM, Lei X, Buzdar AU, Valero V, Melhem-Bertrandt A, Kuerer HM, Hortobagyi GN, Sahin AA, Meric-Bernstam F. (2012) Efficacy of neoadjuvant therapy with trastuzumab concurrent with anthracycline- and nonanthracycline-based regimens for HER2-positive breast cancer. Cancer. 118(9):2385−2393. https://doi.org/10.1002/cncr.26555. Bayraktar S, Gonzalez-Angulo AM, Lei X, Buzdar AU, Valero V, Melhem-Bertrandt A, Kuerer HM, Hortobagyi GN, Sahin AA, Meric-Bernstam F. (2012) Efficacy of neoadjuvant therapy with trastuzumab concurrent with anthracycline- and nonanthracycline-based regimens for HER2-positive breast cancer. Cancer. 118(9):2385−2393. https://​doi.​org/​10.​1002/​cncr.​26555.
19.
Zurück zum Zitat Langley RE, Carmichael J, Jones AL, Cameron DA, Qian W, Uscinska B, Howell A, Parmar M. (2005) Phase III trial of epirubicin plus paclitaxel compared with epirubicin plus cyclophosphamide as first-line chemotherapy for metastatic breast cancer: United Kingdom National Cancer Research Institute trial AB01. J Clin Oncol 23(33):8322−8330. https://doi.org/10.1200/JCO.2005.01.1817. Langley RE, Carmichael J, Jones AL, Cameron DA, Qian W, Uscinska B, Howell A, Parmar M. (2005) Phase III trial of epirubicin plus paclitaxel compared with epirubicin plus cyclophosphamide as first-line chemotherapy for metastatic breast cancer: United Kingdom National Cancer Research Institute trial AB01. J Clin Oncol 23(33):8322−8330. https://​doi.​org/​10.​1200/​JCO.​2005.​01.​1817.
20.
Zurück zum Zitat Schmid P, Cortes J, Pusztai L, McArthur H, Kümmel S, Bergh J, Denkert C, Park YH, Hui R, Harbeck N, Takahashi M, Foukakis T, Fasching PA, Cardoso F, Untch M, Jia L, Karantza V, Zhao J, Aktan G, Dent R, O'Shaughnessy J; KEYNOTE-522 Investigators (2020) Pembrolizumab for Early Triple-Negative Breast Cancer. N Engl J Med. 382(9):810−821. https://doi.org/10.1056/NEJMoa1910549. Schmid P, Cortes J, Pusztai L, McArthur H, Kümmel S, Bergh J, Denkert C, Park YH, Hui R, Harbeck N, Takahashi M, Foukakis T, Fasching PA, Cardoso F, Untch M, Jia L, Karantza V, Zhao J, Aktan G, Dent R, O'Shaughnessy J; KEYNOTE-522 Investigators (2020) Pembrolizumab for Early Triple-Negative Breast Cancer. N Engl J Med. 382(9):810−821. https://​doi.​org/​10.​1056/​NEJMoa1910549.
21.
Zurück zum Zitat Tilly H, Morschhauser F, Sehn LH, Friedberg JW, Trněný M, Sharman JP, Herbaux C, Burke JM, Matasar M, Rai S, Izutsu K, Mehta-Shah N, Oberic L, Chauchet A, Jurczak W, Song Y, Greil R, Mykhalska L, Bergua-Burgués JM, Cheung MC, Pinto A, Shin HJ, Hapgood G, Munhoz E, Abrisqueta P, Gau JP, Hirata J, Jiang Y, Yan M, Lee C, Flowers CR, Salles G. (2022) Polatuzumab Vedotin in Previously Untreated Diffuse Large B-Cell Lymphoma. N Engl J Med. 386(4):351–363. https://doi.org/10.1056/NEJMoa2115304. Tilly H, Morschhauser F, Sehn LH, Friedberg JW, Trněný M, Sharman JP, Herbaux C, Burke JM, Matasar M, Rai S, Izutsu K, Mehta-Shah N, Oberic L, Chauchet A, Jurczak W, Song Y, Greil R, Mykhalska L, Bergua-Burgués JM, Cheung MC, Pinto A, Shin HJ, Hapgood G, Munhoz E, Abrisqueta P, Gau JP, Hirata J, Jiang Y, Yan M, Lee C, Flowers CR, Salles G. (2022) Polatuzumab Vedotin in Previously Untreated Diffuse Large B-Cell Lymphoma. N Engl J Med. 386(4):351–363. https://​doi.​org/​10.​1056/​NEJMoa2115304.
22.
Zurück zum Zitat Hiddemann W, Barbui AM, Canales MA, Cannell PK, Collins GP, Dürig J, Forstpointner R, Herold M, Hertzberg M, Klanova M, Radford J, Seymour JF, Tobinai K, Trotman J, Burciu A, Fingerle-Rowson G, Wolbers M, Nielsen T, Marcus RE. (2018) Immunochemotherapy With Obinutuzumab or Rituximab for Previously Untreated Follicular Lymphoma in the GALLIUM Study: Influence of Chemotherapy on Efficacy and Safety. J Clin Oncol. 36(23):2395–2404. https://doi.org/10.1200/JCO.2017.76.8960. Hiddemann W, Barbui AM, Canales MA, Cannell PK, Collins GP, Dürig J, Forstpointner R, Herold M, Hertzberg M, Klanova M, Radford J, Seymour JF, Tobinai K, Trotman J, Burciu A, Fingerle-Rowson G, Wolbers M, Nielsen T, Marcus RE. (2018) Immunochemotherapy With Obinutuzumab or Rituximab for Previously Untreated Follicular Lymphoma in the GALLIUM Study: Influence of Chemotherapy on Efficacy and Safety. J Clin Oncol. 36(23):2395–2404. https://​doi.​org/​10.​1200/​JCO.​2017.​76.​8960.
23.
Zurück zum Zitat Wang M, Fayad L, Wagner-Bartak N, Zhang L, Hagemeister F, Neelapu SS, Samaniego F, McLaughlin P, Fanale M, Younes A, Cabanillas F, Fowler N, Newberry KJ, Sun L, Young KH, Champlin R, Kwak L, Feng L, Badillo M, Bejarano M, Hartig K, Chen W, Chen Y, Byrne C, Bell N, Zeldis J, Romaguera J. (2012) Lenalidomide in combination with rituximab for patients with relapsed or refractory mantle-cell lymphoma: a phase 1/2 clinical trial. Lancet Oncol. 13(7):716-723. https://doi.org/10.1016/S1470-2045(12)70200-0. Wang M, Fayad L, Wagner-Bartak N, Zhang L, Hagemeister F, Neelapu SS, Samaniego F, McLaughlin P, Fanale M, Younes A, Cabanillas F, Fowler N, Newberry KJ, Sun L, Young KH, Champlin R, Kwak L, Feng L, Badillo M, Bejarano M, Hartig K, Chen W, Chen Y, Byrne C, Bell N, Zeldis J, Romaguera J. (2012) Lenalidomide in combination with rituximab for patients with relapsed or refractory mantle-cell lymphoma: a phase 1/2 clinical trial. Lancet Oncol. 13(7):716-723. https://​doi.​org/​10.​1016/​S1470-2045(12)70200-0.
24.
Zurück zum Zitat Helbekkmo N, Sundstrøm SH, Aasebø U, Brunsvig PF, von Plessen C, Hjelde HH, Garpestad OK, Bailey A, Bremnes RM; Norwegian Lung Cancer Study Group. (2007) Vinorelbine/carboplatin vs gemcitabine/carboplatin in advanced NSCLC shows similar efficacy, but different impact of toxicity. Br J Cancer. 97(3):283–289. https://doi.org/10.1038/sj.bjc.6603869. Helbekkmo N, Sundstrøm SH, Aasebø U, Brunsvig PF, von Plessen C, Hjelde HH, Garpestad OK, Bailey A, Bremnes RM; Norwegian Lung Cancer Study Group. (2007) Vinorelbine/carboplatin vs gemcitabine/carboplatin in advanced NSCLC shows similar efficacy, but different impact of toxicity. Br J Cancer. 97(3):283–289. https://​doi.​org/​10.​1038/​sj.​bjc.​6603869.
25.
Zurück zum Zitat Sugawara S, Lee JS, Kang JH, Kim HR, Inui N, Hida T, Lee KH, Yoshida T, Tanaka H, Yang CT, Nishio M, Ohe Y, Tamura T, Yamamoto N, Yu CJ, Akamatsu H, Namba Y, Sumiyoshi N, Nakagawa K. (2021) Nivolumab with carboplatin, paclitaxel, and bevacizumab for first-line treatment of advanced nonsquamous non-small-cell lung cancer. Ann Oncol. 32(9):1137–1147. https://doi.org/10.1016/j.annonc.2021.06.004. Sugawara S, Lee JS, Kang JH, Kim HR, Inui N, Hida T, Lee KH, Yoshida T, Tanaka H, Yang CT, Nishio M, Ohe Y, Tamura T, Yamamoto N, Yu CJ, Akamatsu H, Namba Y, Sumiyoshi N, Nakagawa K. (2021) Nivolumab with carboplatin, paclitaxel, and bevacizumab for first-line treatment of advanced nonsquamous non-small-cell lung cancer. Ann Oncol. 32(9):1137–1147. https://​doi.​org/​10.​1016/​j.​annonc.​2021.​06.​004.
26.
Zurück zum Zitat Socinski MA, Jotte RM, Cappuzzo F, Orlandi F, Stroyakovskiy D, Nogami N, Rodríguez-Abreu D, Moro-Sibilot D, Thomas CA, Barlesi F, Finley G, Kelsch C, Lee A, Coleman S, Deng Y, Shen Y, Kowanetz M, Lopez-Chavez A, Sandler A, Reck M (2018) IMpower150 Study Group. Atezolizumab for First-Line Treatment of Metastatic Nonsquamous NSCLC. N Engl J Med. 378(24):2288–2301. https://doi.org/10.1056/NEJMoa1716948 Socinski MA, Jotte RM, Cappuzzo F, Orlandi F, Stroyakovskiy D, Nogami N, Rodríguez-Abreu D, Moro-Sibilot D, Thomas CA, Barlesi F, Finley G, Kelsch C, Lee A, Coleman S, Deng Y, Shen Y, Kowanetz M, Lopez-Chavez A, Sandler A, Reck M (2018) IMpower150 Study Group. Atezolizumab for First-Line Treatment of Metastatic Nonsquamous NSCLC. N Engl J Med. 378(24):2288–2301. https://​doi.​org/​10.​1056/​NEJMoa1716948
27.
Zurück zum Zitat Griffiths EA (2021) NCCN Guidelines Version 3.2021, Hematopoietic growth factors. NCCN Clinical Practice GUIDELINES in Oncology (NCCN Guidelines) Griffiths EA (2021) NCCN Guidelines Version 3.2021, Hematopoietic growth factors. NCCN Clinical Practice GUIDELINES in Oncology (NCCN Guidelines)
35.
36.
Zurück zum Zitat Kuderer NM, Dale DC, Crawford J, Cosler LE, Lyman GH (2006) Mortality, morbidity, and cost associated with febrile neutropenia in adult cancer patients. Cancer 106:2258–2266CrossRef Kuderer NM, Dale DC, Crawford J, Cosler LE, Lyman GH (2006) Mortality, morbidity, and cost associated with febrile neutropenia in adult cancer patients. Cancer 106:2258–2266CrossRef
37.
Zurück zum Zitat Smith TJ, Khatcheressian J, Lyman GH, Ozer H, Armitage JO, Balducci L et al (2006) 2006 update of recommendations for the use of white blood cell growth factors: an evidence-based clinical practice guideline. J Clin Oncol 24:3187–3205CrossRef Smith TJ, Khatcheressian J, Lyman GH, Ozer H, Armitage JO, Balducci L et al (2006) 2006 update of recommendations for the use of white blood cell growth factors: an evidence-based clinical practice guideline. J Clin Oncol 24:3187–3205CrossRef
38.
Zurück zum Zitat Holmes FA, O’Shaughnessy JA, Vukelja S, Jones SE, Shogan J, Savin M et al (2002) Blinded, randomized, multicenter study to evaluate single administration pegfilgrastim once per cycle versus daily filgrastim as an adjunct to chemotherapy in patients with high-risk stage II or stage III/IV breast cancer. J Clinoncol 20:727–731CrossRef Holmes FA, O’Shaughnessy JA, Vukelja S, Jones SE, Shogan J, Savin M et al (2002) Blinded, randomized, multicenter study to evaluate single administration pegfilgrastim once per cycle versus daily filgrastim as an adjunct to chemotherapy in patients with high-risk stage II or stage III/IV breast cancer. J Clinoncol 20:727–731CrossRef
39.
Zurück zum Zitat Vogel CL, Wojtukiewicz MZ, Carroll RR, Tjulandin SA, Barajas-Figueroa LJ, Wiens BL et al (2005) First and subsequent cycle use of pegfilgrastim prevents febrile neutropenia in patients with breast cancer: a multicenter, double-blind, placebo-controlled phase III study. J Clin Oncol 23(6):1178–1184CrossRef Vogel CL, Wojtukiewicz MZ, Carroll RR, Tjulandin SA, Barajas-Figueroa LJ, Wiens BL et al (2005) First and subsequent cycle use of pegfilgrastim prevents febrile neutropenia in patients with breast cancer: a multicenter, double-blind, placebo-controlled phase III study. J Clin Oncol 23(6):1178–1184CrossRef
40.
Zurück zum Zitat Green MD, Koelbl H, Baselga J, Galid A, Guillem V, Gascon P et al (2003) A randomized double-blind multicenter phase III study of fixed-dose single-administration pegfilgrastim versus daily filgrastim in patients receiving myelosuppressive chemotherapy. Ann Oncol 14(1):29–35. https://doi.org/10.1093/annonc/mdg019CrossRefPubMed Green MD, Koelbl H, Baselga J, Galid A, Guillem V, Gascon P et al (2003) A randomized double-blind multicenter phase III study of fixed-dose single-administration pegfilgrastim versus daily filgrastim in patients receiving myelosuppressive chemotherapy. Ann Oncol 14(1):29–35. https://​doi.​org/​10.​1093/​annonc/​mdg019CrossRefPubMed
41.
Zurück zum Zitat Martin M, Lluch A, Segui MA, Ruiz A, Ramos M, Adrover E et al (2006) Toxicity and health-related quality of life in breast cancer patients receiving adjuvant docetaxel, doxorubicin, cyclophosphamide (TAC) or 5‑fluorouracil, doxorubicin and cyclophosphamide (FAC): impact of adding primary prophylactic granulocyte-colony stimulating factor to the TAC regimen. Ann Oncol 17(8):1205–1212CrossRef Martin M, Lluch A, Segui MA, Ruiz A, Ramos M, Adrover E et al (2006) Toxicity and health-related quality of life in breast cancer patients receiving adjuvant docetaxel, doxorubicin, cyclophosphamide (TAC) or 5‑fluorouracil, doxorubicin and cyclophosphamide (FAC): impact of adding primary prophylactic granulocyte-colony stimulating factor to the TAC regimen. Ann Oncol 17(8):1205–1212CrossRef
42.
Zurück zum Zitat Kuderer NM, Dale DC, Crawford J, Lyman GH (2007) Impact of primary prophylaxis with granulocyte colony-stimulating factor on febrile neutropenia and mortality in adult cancer patients receiving chemotherapy: a systematic review. J Clin Oncol 25:3158–3167CrossRef Kuderer NM, Dale DC, Crawford J, Lyman GH (2007) Impact of primary prophylaxis with granulocyte colony-stimulating factor on febrile neutropenia and mortality in adult cancer patients receiving chemotherapy: a systematic review. J Clin Oncol 25:3158–3167CrossRef
44.
Zurück zum Zitat Supportive Therapie bei onkologischen PatientInnen – Langversion 1.0, 2016, AWMF Registernummer: 032/054OL. Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF). Berlin: DKG, ASORS, DGHO, DEGRO. Leitlinienprogramm Onkologie der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e. V. (AWMF), Deutschen Krebsgesellschaft e. V. (DKG) und Deutschen Krebshilfe (DKH); 2016. http://leitlinienprogramm-onkologie.de/Supportive-Therapie.95.0.html Supportive Therapie bei onkologischen PatientInnen – Langversion 1.0, 2016, AWMF Registernummer: 032/054OL. Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF). Berlin: DKG, ASORS, DGHO, DEGRO. Leitlinienprogramm Onkologie der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e. V. (AWMF), Deutschen Krebsgesellschaft e. V. (DKG) und Deutschen Krebshilfe (DKH); 2016. http://​leitlinienprogra​mm-onkologie.​de/​Supportive-Therapie.​95.​0.​html
45.
46.
Zurück zum Zitat Aapro MS, Bohlius J, Cameron DA, Dal LL, Donnelly JP, Kearney N et al (2011) 2010 update of EORTC guidelines for the use of granulocyte-colony stimulating factor to reduce the incidence of chemotherapy-induced febrile neutropenia in adult patients with lymphoproliferative disorders and solid tumours. Eur J Cancer 47(1):8–32CrossRef Aapro MS, Bohlius J, Cameron DA, Dal LL, Donnelly JP, Kearney N et al (2011) 2010 update of EORTC guidelines for the use of granulocyte-colony stimulating factor to reduce the incidence of chemotherapy-induced febrile neutropenia in adult patients with lymphoproliferative disorders and solid tumours. Eur J Cancer 47(1):8–32CrossRef
47.
48.
Zurück zum Zitat Aarts MJ, Peters FP, Mandigers CM, Dercksen MW, Stouthard JM, Nortier HJ et al (2013) Primary granulocyte colony-stimulating factor prophylaxis during the first two cycles only or throughout all chemotherapy cycles in patients with breast cancer at risk for febrile neutropenia. J Clin Oncol 31(34):4290–4296. https://doi.org/10.1200/JCO.2012.44.6229CrossRefPubMed Aarts MJ, Peters FP, Mandigers CM, Dercksen MW, Stouthard JM, Nortier HJ et al (2013) Primary granulocyte colony-stimulating factor prophylaxis during the first two cycles only or throughout all chemotherapy cycles in patients with breast cancer at risk for febrile neutropenia. J Clin Oncol 31(34):4290–4296. https://​doi.​org/​10.​1200/​JCO.​2012.​44.​6229CrossRefPubMed
50.
Zurück zum Zitat Leonard RC, Mansi JL, Keerie C, Yellowlees A, Crawford S, Benstead K et al (2015) A randomised trial of secondary prophylaxis using granulocyte colony-stimulating factor (‘SPROG’ trial) for maintaining dose intensity of standard adjuvant chemotherapy for breast cancer by the Anglo-Celtic Cooperative Group and NCRN. Ann Oncol 26(12):2437–2441. https://doi.org/10.1093/annonc/mdv389CrossRefPubMed Leonard RC, Mansi JL, Keerie C, Yellowlees A, Crawford S, Benstead K et al (2015) A randomised trial of secondary prophylaxis using granulocyte colony-stimulating factor (‘SPROG’ trial) for maintaining dose intensity of standard adjuvant chemotherapy for breast cancer by the Anglo-Celtic Cooperative Group and NCRN. Ann Oncol 26(12):2437–2441. https://​doi.​org/​10.​1093/​annonc/​mdv389CrossRefPubMed
51.
Zurück zum Zitat Pfeil AM, Allcott K, Pettengell R, von Minckwitz G, Schwenkglenks M, Szabo Z (2015) Efficacy, effectiveness and safety of long-acting granulocyte colony-stimulating factors for prophylaxis of chemotherapy-induced neutropenia in patients with cancer: a systematic review. Support Care Cancer 23(2):525–545. https://doi.org/10.1007/s00520-014-2457-zCrossRefPubMed Pfeil AM, Allcott K, Pettengell R, von Minckwitz G, Schwenkglenks M, Szabo Z (2015) Efficacy, effectiveness and safety of long-acting granulocyte colony-stimulating factors for prophylaxis of chemotherapy-induced neutropenia in patients with cancer: a systematic review. Support Care Cancer 23(2):525–545. https://​doi.​org/​10.​1007/​s00520-014-2457-zCrossRefPubMed
52.
Zurück zum Zitat Pinto L, Liu Z, Doan Q, Bernal M, Dubois R, Lyman G (2007) Comparison of pegfilgrastim with filgrastim on febrile neutropenia, grade IV neutropenia and bone pain: a meta-analysis of randomized controlled trials. Curr Med Res Opin 23:2283–2295CrossRef Pinto L, Liu Z, Doan Q, Bernal M, Dubois R, Lyman G (2007) Comparison of pegfilgrastim with filgrastim on febrile neutropenia, grade IV neutropenia and bone pain: a meta-analysis of randomized controlled trials. Curr Med Res Opin 23:2283–2295CrossRef
53.
Zurück zum Zitat Bond TC, Szabo E, Gabriel S, Klastersky J, Tomey O, Mueller U et al (2018) Meta-analysis and indirect treatment comparison of lipegfilgrastim with pegfilgrastim and filgrastim for the reduction of chemotherapy-induced neutropenia-related events. J Oncol Pharm Pract 24(6):412–423. https://doi.org/10.1177/1078155217714859CrossRefPubMed Bond TC, Szabo E, Gabriel S, Klastersky J, Tomey O, Mueller U et al (2018) Meta-analysis and indirect treatment comparison of lipegfilgrastim with pegfilgrastim and filgrastim for the reduction of chemotherapy-induced neutropenia-related events. J Oncol Pharm Pract 24(6):412–423. https://​doi.​org/​10.​1177/​1078155217714859​CrossRefPubMed
54.
Zurück zum Zitat Link H, Illerhaus G, Martens UM, Salar A, Depenbusch R, Kohler A et al (2021) Efficacy and safety of lipegfilgrastim versus pegfilgrastim in elderly patients with aggressive B cell non-Hodgkin lymphoma (B-NHL): results of the randomized, open-label, non-inferiority AVOID neutropenia study. Support Care Cancer 29(5):2519–2527. https://doi.org/10.1007/s00520-020-05711-7CrossRefPubMed Link H, Illerhaus G, Martens UM, Salar A, Depenbusch R, Kohler A et al (2021) Efficacy and safety of lipegfilgrastim versus pegfilgrastim in elderly patients with aggressive B cell non-Hodgkin lymphoma (B-NHL): results of the randomized, open-label, non-inferiority AVOID neutropenia study. Support Care Cancer 29(5):2519–2527. https://​doi.​org/​10.​1007/​s00520-020-05711-7CrossRefPubMed
56.
57.
Zurück zum Zitat Lyman GH, Allcott K, Garcia J, Stryker S, Li Y, Reiner MT et al (2017) The effectiveness and safety of same-day versus next-day administration of long-acting granulocyte colony-stimulating factors for the prophylaxis of chemotherapy-induced neutropenia: a systematic review. Support Care Cancer 25(8):2619–2629. https://doi.org/10.1007/s00520-017-3703-yCrossRefPubMed Lyman GH, Allcott K, Garcia J, Stryker S, Li Y, Reiner MT et al (2017) The effectiveness and safety of same-day versus next-day administration of long-acting granulocyte colony-stimulating factors for the prophylaxis of chemotherapy-induced neutropenia: a systematic review. Support Care Cancer 25(8):2619–2629. https://​doi.​org/​10.​1007/​s00520-017-3703-yCrossRefPubMed
59.
Zurück zum Zitat Kirshner JJ, Heckler CE, Janelsins MC, Dakhil SR, Hopkins JO, Coles C et al (2012) Prevention of pegfilgrastim-induced bone pain: a phase III double-blind placebo-controlled randomized clinical trial of the university of rochester cancer center clinical community oncology program research base. J Clin Oncol 30(16):1974–1979. https://doi.org/10.1200/JCO.2011.37.8364CrossRefPubMedPubMedCentral Kirshner JJ, Heckler CE, Janelsins MC, Dakhil SR, Hopkins JO, Coles C et al (2012) Prevention of pegfilgrastim-induced bone pain: a phase III double-blind placebo-controlled randomized clinical trial of the university of rochester cancer center clinical community oncology program research base. J Clin Oncol 30(16):1974–1979. https://​doi.​org/​10.​1200/​JCO.​2011.​37.​8364CrossRefPubMedPubMedCentral
60.
Zurück zum Zitat Kirshner JJ, McDonald MC, Kruter F, Guinigundo AS, Vanni L, Maxwell CL et al (2018) NOLAN: a randomized, phase 2 study to estimate the effect of prophylactic naproxen or loratadine vs no prophylactic treatment on bone pain in patients with early-stage breast cancer receiving chemotherapy and pegfilgrastim. Support Care Cancer 26(4):1323–1334. https://doi.org/10.1007/s00520-017-3959-2CrossRefPubMed Kirshner JJ, McDonald MC, Kruter F, Guinigundo AS, Vanni L, Maxwell CL et al (2018) NOLAN: a randomized, phase 2 study to estimate the effect of prophylactic naproxen or loratadine vs no prophylactic treatment on bone pain in patients with early-stage breast cancer receiving chemotherapy and pegfilgrastim. Support Care Cancer 26(4):1323–1334. https://​doi.​org/​10.​1007/​s00520-017-3959-2CrossRefPubMed
69.
Zurück zum Zitat Ganz T (2011) Hepcidin and iron regulation, 10 years later. Blood 117:4425–4433CrossRef Ganz T (2011) Hepcidin and iron regulation, 10 years later. Blood 117:4425–4433CrossRef
71.
Zurück zum Zitat Katodritou E, Terpos E, Zervas K, Speletas M, Kapetanos D, Kartsios C et al (2007) Hypochromic erythrocytes (%): a reliable marker for recognizing iron-restricted erythropoiesis and predicting response to erythropoietin in anemic patients with myeloma and lymphoma. Ann Hematol 86:369–376CrossRef Katodritou E, Terpos E, Zervas K, Speletas M, Kapetanos D, Kartsios C et al (2007) Hypochromic erythrocytes (%): a reliable marker for recognizing iron-restricted erythropoiesis and predicting response to erythropoietin in anemic patients with myeloma and lymphoma. Ann Hematol 86:369–376CrossRef
72.
Zurück zum Zitat Auerbach M, Ballard H, Trout JR, McIlwain M, Ackerman A, Bahrain H et al (2004) Intravenous iron optimizes the response to recombinant human erythropoietin in cancer patients with chemotherapy-related anemia: a multicenter, open-label, randomized trial. J Clin Oncol 22(7):1301–1307CrossRef Auerbach M, Ballard H, Trout JR, McIlwain M, Ackerman A, Bahrain H et al (2004) Intravenous iron optimizes the response to recombinant human erythropoietin in cancer patients with chemotherapy-related anemia: a multicenter, open-label, randomized trial. J Clin Oncol 22(7):1301–1307CrossRef
73.
Zurück zum Zitat Bovy C, Gothot A, Delanaye P, Warling X, Krzesinski JM, Beguin Y (2007) Mature erythrocyte parameters as new markers of functional iron deficiency in haemodialysis: sensitivity and specificity. Nephrol Dial Transplant 22(4):1156–1162CrossRef Bovy C, Gothot A, Delanaye P, Warling X, Krzesinski JM, Beguin Y (2007) Mature erythrocyte parameters as new markers of functional iron deficiency in haemodialysis: sensitivity and specificity. Nephrol Dial Transplant 22(4):1156–1162CrossRef
74.
Zurück zum Zitat Littlewood TJ, Bajetta E, Nortier JW, Vercammen E, Rapoport B (2001) Effects of epoetin alfa on hematologic parameters and quality of life in cancer patients receiving nonplatinum chemotherapy: results of a randomized, double-blind, placebo-controlled trial. J Clin Oncol 19:2865–2874CrossRef Littlewood TJ, Bajetta E, Nortier JW, Vercammen E, Rapoport B (2001) Effects of epoetin alfa on hematologic parameters and quality of life in cancer patients receiving nonplatinum chemotherapy: results of a randomized, double-blind, placebo-controlled trial. J Clin Oncol 19:2865–2874CrossRef
75.
Zurück zum Zitat Witzig TE, Silberstein PT, Loprinzi CL, Sloan JA, Novotny PJ, Mailliard JA et al (2005) Phase III, randomized, double-blind study of epoetin alfa compared with placebo in anemic patients receiving chemotherapy. J Clin Oncol 23(12):2606–2617CrossRef Witzig TE, Silberstein PT, Loprinzi CL, Sloan JA, Novotny PJ, Mailliard JA et al (2005) Phase III, randomized, double-blind study of epoetin alfa compared with placebo in anemic patients receiving chemotherapy. J Clin Oncol 23(12):2606–2617CrossRef
76.
Zurück zum Zitat Querschnitts-Leitlinien BAEK zur Therapie mit Blutkomponenten und Plasmaderivaten-Gesamtnovelle 2020. Berlin: Bundesärztekammer; 2020. Querschnitts-Leitlinien BAEK zur Therapie mit Blutkomponenten und Plasmaderivaten-Gesamtnovelle 2020. Berlin: Bundesärztekammer; 2020.
77.
Zurück zum Zitat Funk MB, Heiden M, Müller S et al (2021) Hämovigilanz-Bericht des Paul-Ehrlich-Instituts 2019: Auswertung der Meldungen von Reaktionen und Zwischenfällen nach § 63i AMG Funk MB, Heiden M, Müller S et al (2021) Hämovigilanz-Bericht des Paul-Ehrlich-Instituts 2019: Auswertung der Meldungen von Reaktionen und Zwischenfällen nach § 63i AMG
81.
Zurück zum Zitat Musallam KM, Tamim HM, Richards T, Spahn DR, Rosendaal FR, Habbal A et al (2011) Preoperative anaemia and postoperative outcomes in non-cardiac surgery: a retrospective cohort study. Lancet 378(9800):1396–1407CrossRef Musallam KM, Tamim HM, Richards T, Spahn DR, Rosendaal FR, Habbal A et al (2011) Preoperative anaemia and postoperative outcomes in non-cardiac surgery: a retrospective cohort study. Lancet 378(9800):1396–1407CrossRef
82.
Zurück zum Zitat Hebert PC, Wells G, Blajchman MA, Marshall J, Martin C, Pagliarello G et al (1999) A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. N Engl J Med 340:409–417CrossRef Hebert PC, Wells G, Blajchman MA, Marshall J, Martin C, Pagliarello G et al (1999) A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. N Engl J Med 340:409–417CrossRef
83.
Zurück zum Zitat Villanueva C, Colomo A, Bosch A, Concepcion M, Hernandez-Gea V, Aracil C et al (2013) Transfusion strategies for acute upper gastrointestinal bleeding. N Engl J Med 368:11–21CrossRef Villanueva C, Colomo A, Bosch A, Concepcion M, Hernandez-Gea V, Aracil C et al (2013) Transfusion strategies for acute upper gastrointestinal bleeding. N Engl J Med 368:11–21CrossRef
86.
Zurück zum Zitat Carson JL, Terrin ML, Noveck H, Sanders DW, Chaitman BR, Rhoads GG et al (2011) Liberal or restrictive transfusion in high-risk patients after hip surgery. N Engl J Med 365:2453–2462CrossRef Carson JL, Terrin ML, Noveck H, Sanders DW, Chaitman BR, Rhoads GG et al (2011) Liberal or restrictive transfusion in high-risk patients after hip surgery. N Engl J Med 365:2453–2462CrossRef
89.
Zurück zum Zitat Mortensen FV, Jensen LS, Sörensen HT, Pedersen L (2011) Cause-specific mortality associated with leukoreduced, buffy coat–depleted, or no blood transfusion after elective surgery for colorectal cancer: a posttrial 15-year follow-up study. Transfusion 51:259–263CrossRef Mortensen FV, Jensen LS, Sörensen HT, Pedersen L (2011) Cause-specific mortality associated with leukoreduced, buffy coat–depleted, or no blood transfusion after elective surgery for colorectal cancer: a posttrial 15-year follow-up study. Transfusion 51:259–263CrossRef
90.
Zurück zum Zitat Castillo JJ, Dalia S, Pascual SK (2010) Association between red blood cell transfusions and development of non-hodgkin lymphoma: a meta-analysis of observational studies. Blood 116:2897–2907CrossRef Castillo JJ, Dalia S, Pascual SK (2010) Association between red blood cell transfusions and development of non-hodgkin lymphoma: a meta-analysis of observational studies. Blood 116:2897–2907CrossRef
92.
Zurück zum Zitat Leahy MF, Hofmann A, Towler S, Trentino KM, Burrows SA, Swain SG et al (2017) Improved outcomes and reduced costs associated with a health-system-wide patient blood management program: a retrospective observational study in four major adult tertiary-care hospitals. Transfusion 57(6):1347–1358. https://doi.org/10.1111/trf.14006CrossRefPubMed Leahy MF, Hofmann A, Towler S, Trentino KM, Burrows SA, Swain SG et al (2017) Improved outcomes and reduced costs associated with a health-system-wide patient blood management program: a retrospective observational study in four major adult tertiary-care hospitals. Transfusion 57(6):1347–1358. https://​doi.​org/​10.​1111/​trf.​14006CrossRefPubMed
94.
Zurück zum Zitat Hedenus M, Adriansson M, San MJ, Kramer MH, Schipperus MR, Juvonen E et al (2003) Efficacy and safety of darbepoetin alfa in anaemic patients with lymphoproliferative malignancies: a randomized, double-blind, placebo-controlled study. Br J Haematol 122:394–403CrossRef Hedenus M, Adriansson M, San MJ, Kramer MH, Schipperus MR, Juvonen E et al (2003) Efficacy and safety of darbepoetin alfa in anaemic patients with lymphoproliferative malignancies: a randomized, double-blind, placebo-controlled study. Br J Haematol 122:394–403CrossRef
95.
Zurück zum Zitat Chang J, Couture F, Young S, McWatters KL, Lau CY (2005) Weekly epoetin alfa maintains hemoglobin, improves quality of life, and reduces transfusion in breast cancer patients receiving chemotherapy. J Clin Oncol 23(12):2597–2605CrossRef Chang J, Couture F, Young S, McWatters KL, Lau CY (2005) Weekly epoetin alfa maintains hemoglobin, improves quality of life, and reduces transfusion in breast cancer patients receiving chemotherapy. J Clin Oncol 23(12):2597–2605CrossRef
96.
Zurück zum Zitat Bokemeyer C, Aapro MS, Courdi A, Foubert J, Link H, Osterborg A et al (2007) EORTC guidelines for the use of erythropoietic proteins in anaemic patients with cancer: 2006 update. Eur J Cancer 43:258–270CrossRef Bokemeyer C, Aapro MS, Courdi A, Foubert J, Link H, Osterborg A et al (2007) EORTC guidelines for the use of erythropoietic proteins in anaemic patients with cancer: 2006 update. Eur J Cancer 43:258–270CrossRef
97.
Zurück zum Zitat Corwin HL (2006) The role of erythropoietin therapy in the critically ill. Transfus Med Rev 20(1):27–33CrossRef Corwin HL (2006) The role of erythropoietin therapy in the critically ill. Transfus Med Rev 20(1):27–33CrossRef
98.
Zurück zum Zitat Vansteenkiste J, Pirker R, Massuti B, Barata F, Font A, Fiegl M et al (2002) Double-blind, placebo-controlled, randomized phase III trial of darbepoetin alfa in lung cancer patients receiving chemotherapy. J Natl Cancer Inst 94:1211–1220CrossRef Vansteenkiste J, Pirker R, Massuti B, Barata F, Font A, Fiegl M et al (2002) Double-blind, placebo-controlled, randomized phase III trial of darbepoetin alfa in lung cancer patients receiving chemotherapy. J Natl Cancer Inst 94:1211–1220CrossRef
99.
Zurück zum Zitat Bastit L, Vandebroek A, Altintas S, Gaede B, Pinter T, Suto TS et al (2008) Randomized, multicenter, controlled trial comparing the efficacy and safety of darbepoetin alfa administered every 3 weeks with or without intravenous iron in patients with chemotherapy-induced anemia. J Clin Oncol 26:1611–1618CrossRef Bastit L, Vandebroek A, Altintas S, Gaede B, Pinter T, Suto TS et al (2008) Randomized, multicenter, controlled trial comparing the efficacy and safety of darbepoetin alfa administered every 3 weeks with or without intravenous iron in patients with chemotherapy-induced anemia. J Clin Oncol 26:1611–1618CrossRef
103.
Zurück zum Zitat Goodnough LT, Skikne B, Brugnara C (2000) Erythropoietin, iron, and erythropoiesis. Blood 96(3):823–833CrossRef Goodnough LT, Skikne B, Brugnara C (2000) Erythropoietin, iron, and erythropoiesis. Blood 96(3):823–833CrossRef
104.
Zurück zum Zitat Steensma DP, Sloan JA, Dakhil SR, Dalton R, Kahanic SP, Prager DJ et al (2011) Phase III, randomized study of the effects of parenteral iron, oral iron, or no iron supplementation on the erythropoietic response to darbepoetin alfa for patients with chemotherapy-associated anemia. J Clin Oncol 29:97–105CrossRef Steensma DP, Sloan JA, Dakhil SR, Dalton R, Kahanic SP, Prager DJ et al (2011) Phase III, randomized study of the effects of parenteral iron, oral iron, or no iron supplementation on the erythropoietic response to darbepoetin alfa for patients with chemotherapy-associated anemia. J Clin Oncol 29:97–105CrossRef
Metadaten
Titel
G-CSF zur Prophylaxe der Neutropenie und der febrilen Neutropenie, Anämie bei Krebserkrankung
Supportivtherapieleitlinien, Teil 1
verfasst von
Hartmut Link
Publikationsdatum
20.06.2022
Verlag
Springer Medizin
Erschienen in
best practice onkologie / Ausgabe 6/2022
Print ISSN: 0946-4565
Elektronische ISSN: 1862-8559
DOI
https://doi.org/10.1007/s11654-022-00398-0

Weitere Artikel der Ausgabe 6/2022

best practice onkologie 6/2022 Zur Ausgabe

Editorial

Editorial

Kongresse - wichtig zu wissen

Wichtige Studien vom ASH 2021

onko-aktuell

onko-aktuell

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.