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      Role of recombinant human granulocyte colony-stimulating factor in development of cancer-associated venous thromboembolism in lung cancer patients who undergo chemotherapy

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          Abstract

          Background

          The role of recombinant human granulocyte colony-stimulating factor (rhG-CSF), especially the long-acting factor in the development of cancer-associated venous thromboembolism (VTE) in lung cancer patients who undergo chemotherapy has been understudied, although the use of rhG-CSF has been reported to be associated with an increased risk of VTE.

          Methods

          We retrospectively reviewed 1,673 lung cancer patients who underwent hospitalized chemotherapy. We performed propensity score matching to offset confounding factors related to cancer-associated VTE development and classified the patients into short-acting (N = 273), long-acting (N = 273), and no rhG-CSF (N = 273) groups. The primary outcome was cumulative cancer-associated VTE development three months after all cycles of chemotherapy.

          Results

          The overall VTE incidence in the short-acting, long-acting, and no rhG-CSF groups was 5.5%, 10.3%, and 2.2%, respectively (P <0.001). The VTE incidence in the long-acting rhG-CSF group was higher than that in the short-acting (P = 0.039) and no rhG-CSF groups (P <0.001). The VTE incidence in the short-acting rhG-CSF group was higher than that in the no rhG-CSF group (P = 0.045). The use of rhG-CSF (hazard ratio [HR] 2.337; 95% confidence interval [CI] [1.236–5.251], P = 0.006) was positively correlated with VTE development among all patients, whereas the use of long-acting rhG-CSF (HR 1.917, 95% CI [1.138–4.359]; P = 0.016), was positively correlated with VTE development in patients receiving rhG-CSF.

          Conclusion

          The use of rhG-CSF, especially long-acting rhG-CSF, increases the risk of cancer-associated VTE development compared to no rhG-CSF use in lung cancer patients who undergo hospitalized chemotherapy.

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          Most cited references36

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          Cancer Statistics, 2021

          Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths in the United States and compiles the most recent data on population-based cancer occurrence. Incidence data (through 2017) were collected by the Surveillance, Epidemiology, and End Results Program; the National Program of Cancer Registries; and the North American Association of Central Cancer Registries. Mortality data (through 2018) were collected by the National Center for Health Statistics. In 2021, 1,898,160 new cancer cases and 608,570 cancer deaths are projected to occur in the United States. After increasing for most of the 20th century, the cancer death rate has fallen continuously from its peak in 1991 through 2018, for a total decline of 31%, because of reductions in smoking and improvements in early detection and treatment. This translates to 3.2 million fewer cancer deaths than would have occurred if peak rates had persisted. Long-term declines in mortality for the 4 leading cancers have halted for prostate cancer and slowed for breast and colorectal cancers, but accelerated for lung cancer, which accounted for almost one-half of the total mortality decline from 2014 to 2018. The pace of the annual decline in lung cancer mortality doubled from 3.1% during 2009 through 2013 to 5.5% during 2014 through 2018 in men, from 1.8% to 4.4% in women, and from 2.4% to 5% overall. This trend coincides with steady declines in incidence (2.2%-2.3%) but rapid gains in survival specifically for nonsmall cell lung cancer (NSCLC). For example, NSCLC 2-year relative survival increased from 34% for persons diagnosed during 2009 through 2010 to 42% during 2015 through 2016, including absolute increases of 5% to 6% for every stage of diagnosis; survival for small cell lung cancer remained at 14% to 15%. Improved treatment accelerated progress against lung cancer and drove a record drop in overall cancer mortality, despite slowing momentum for other common cancers.
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            2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS)

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              Neutrophils in cancer: neutral no more.

              Neutrophils are indispensable antagonists of microbial infection and facilitators of wound healing. In the cancer setting, a newfound appreciation for neutrophils has come into view. The traditionally held belief that neutrophils are inert bystanders is being challenged by the recent literature. Emerging evidence indicates that tumours manipulate neutrophils, sometimes early in their differentiation process, to create diverse phenotypic and functional polarization states able to alter tumour behaviour. In this Review, we discuss the involvement of neutrophils in cancer initiation and progression, and their potential as clinical biomarkers and therapeutic targets.
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                Author and article information

                Contributors
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                URI : https://loop.frontiersin.org/people/1325099Role: Role: Role: Role: Role: Role: Role: Role: Role: Role: Role: Role: Role: Role:
                Journal
                Front Immunol
                Front Immunol
                Front. Immunol.
                Frontiers in Immunology
                Frontiers Media S.A.
                1664-3224
                31 May 2024
                2024
                : 15
                : 1386071
                Affiliations
                [1] 1 Department of Pulmonary and Critical Care Medicine, Xinhua Hospital, Shanghai Jiaotong University School of Medicine , Shanghai, China
                [2] 2 Department of Pulmonary and Critical Care Medicine, Punan Hospital , Shanghai, China
                [3] 3 Department of General Practice, North Bund Community Health Service Center , Shanghai, China
                [4] 4 Department of Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine , Shanghai, China
                [5] 5 Department of Traditional Chinese Medicine, Kongjiang Hospital , Shanghai, China
                [6] 6 Department of Intensive Care, Tongxiang First People’s Hospital , Tongxiang, China
                [7] 7 Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University , Kyoto, Japan
                Author notes

                Edited by: Steven Philip Grover, University of North Carolina at Chapel Hill, United States

                Reviewed by: Irma Olarte, Hospital General de México Dr. Eduardo Liceaga, Mexico

                Axel Rosell, Karolinska Institutet (KI), Sweden

                Article
                10.3389/fimmu.2024.1386071
                11176469
                38881899
                e9e9140b-172f-493b-a1cd-0623473f0b50
                Copyright © 2024 Cheng, Zhao, Xu, Du, Sun, Yao, Qu, Liu, Guo and Xiong

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 17 February 2024
                : 07 May 2024
                Page count
                Figures: 2, Tables: 3, Equations: 0, References: 36, Pages: 9, Words: 5348
                Funding
                The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Youth Science Foundation Project of the National Natural Science Foundation of China (82000039) and the International Talent Training Program of the Shanghai Xinhua Hospital (2023YGJRC04).
                Categories
                Immunology
                Original Research
                Custom metadata
                Cancer Immunity and Immunotherapy

                Immunology
                venous thromboembolism,chemotherapy,granulocyte colony-stimulating factor,lung cancer,rhg-csf

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