Hematopoietic Management in Oncology Practice
December 01, 2003
The year 1991 was truly a watershed year in medical oncology,as three events resulted in aparadigm shift in the tolerability,safety, and symptom management ofchemotherapy delivery. The first twoevents moved chemotherapy administrationfrom a user-unfriendly hospitalinpatient environment to whatevolved into a highly efficient, sophisticated,outpatient system led by privatepractitioners of medical oncology.Ondansetron (Zofran), the first of the5HT3-receptor antagonists, providedreliable prophylaxis of immediatechemotherapy-induced nausea andvomiting in highly emetogenic regimens. Recombinant human granulocytecolony-stimulating factor(rhG-CSF, filgrastim [Neupogen]),if dosed appropriately, significantlyreduced the duration of severe neutropeniathrough its role as the primaryregulator of increased production andrelease of granulocytes from the bonemarrow.