Febrile neutropenia and its associated hospitalization in breast cancer patients on docetaxel-containing regimen: A retrospective cohort study on duration of prophylactic GCSF administration.

PURPOSE: To compare febrile neutropenia (FN) incidence and hospitalization among breast cancer patients on docetaxel with no granulocyte colony-stimulating factors (GCSF) primary prophylaxis (PP), 4/5-day PP, or 7-day PP. METHODS: We identified 3916 breast cancer patients using docetaxel-cyclophosphamide (TC), doxorubicin-cyclophosphamide then docetaxel (AC-T), fluorouracil-epirubicin-cyclophosphamide then docetaxel (FEC-T), docetaxel-carboplatin-trastuzumab (TJH), or docetaxel-doxorubicin-cyclophosphamide (TAC) from a hospital pharmacy dispensing database in Hong Kong between 2014 and 2016. Patients were offered GCSF within 5 days since administering docetaxel. Outcomes included FN incidence, time to first hospitalization, hospitalization rate, and duration. RESULTS: In TC regimen, FN incidence (with odds ratio, OR) of patients with no PP, 4/5-day PP, and 7-day PP was 21.69%, 7.95% (OR 0.31, p < 0.001), and 5.33% (OR 0.20, p < 0.001), respectively. In TJH regimen, FN incidence of patients with no PP, 4/5-day PP, and 7-day PP was 38.26%, 8.33% (OR 0.15, p < 0.001), and 8.57% (OR 0.15, p < 0.001), respectively. FN incidence of patients on AC-T regimen with no PP and 4/5-day PP was 20.93% and 6.84%, respectively (OR 0.28, p = 0.005); with FEC-T regimen, the incidence was 9.91% and 4.77%, respectively (OR 0.46, p = 0.035). Only 3.27% FN cases were not hospitalized. Mean (±standard deviation, SD) time to first hospitalization was 8.21 ± 2.44 days. Mean (±SD) duration of hospitalization for patients with no PP, 4/5-day PP, and 7-day PP was 4.66 ± 2.60, 4.37 ± 2.85, and 5.12 ± 2.97 days, respectively. CONCLUSION: GCSF prophylaxis in breast cancer patients on docetaxel could reduce FN incidence and hospitalization. 4/5-day PP demonstrated similar efficacy to 7-day PP with superior saving benefits on healthcare expenditure.

X-ray absorption spectroscopy of the [2Fe-2S] Rieske cluster in Pseudomonas cepacia phthalate dioxygenase. Determination of core dimensions and iron ligation.

We have employed X-ray absorption spectroscopy to obtain structural information about the Rieske Fe/S center in the phthalate dioxygenase (PDO) from Pseudomonas cepacia. Native PDO contains a dinuclear Rieske Fe/S center and an additional mononuclear Fe site. In order to study selectively the Fe/S cluster, we measured data for samples in which the mononuclear site was either depleted of metal or reconstituted with Co or Zn. Our results demonstrate that the iron environment in the Rieske cluster is structurally indistinguishable from that found in other Fe/S clusters, thus strongly supporting the suggestion that the unusually high reduction potentials for Rieske clusters are due to electrostatic rather than structural effects. The average Fe-Fe distance is 2.68 (3) A for both oxidized and reduced Rieske clusters. The average Fe-S distance is 2.24 (2) A in the oxidized cluster and 2.28 (2) A in the reduced cluster. Careful analysis of the EXAFS Debye-Waller factors suggests that the bridging and terminal Fe-S distances for the oxidized cluster are 2.20 and 2.31 A, respectively. Taken together with recent ENDOR results, these studies provide a detailed structural model for the Rieske [2Fe-2S] centers.