Safety and costs of treating neutropenic fever in an outpatient setting.

Purpose: The purpose of this study is to analyze the safety of outpatient treatment for cancer patients with chemotherapy-induced neutropenic fever in a community hospital setting and to compare the costs of outpatient treatment with those of inpatient treatment for such patients.

Patients And Methods: We reviewed charts and charges for 32 consecutive patients initially treated for neutropenic fever with broad-spectrum antibiotics in the offices of Hematology/Oncology Associates (HOA) at the Bennett Cancer Center in the Stamford Hospital January 1997-June 1998. We also reviewed charts and charges for eight consecutive HOA patients with neutropenic fever who met the criteria for outpatient treatment but were initially hospitalized for other reasons during this period.

Low-dose vincristine-associated bilateral vocal cord paralysis.

Background: Vincristine-associated peripheral neuropathy is a well-described entity. We describe a case of vincristine-induced vocal cord paralysis, which is a rare complication of this drug. We report herein the second case of bilateral vocal cord paralysis in a patient receiving conventional doses of vincristine.

Use of cisplatin, cyclophosphamide, vincristine, and doxorubicin for the treatment of non-small cell lung cancer.

Forty-four evaluable patients with non-small cell carcinoma of the lung were treated with cisplatin, cyclophosphamide, vincristine, and doxorubicin. The overall response rate was 57%. The 16% who had complete response had a median survival of 81 weeks.

Multiple myeloma protein with three light chains.

A case of immunoglobulin G (kappa) myeloma showed, in addition to the monoclonal IgG(kappa) arc, two kappa chains in the serum. The urine specimen contained 7.75 g of kappa chains per liter.

Effect of drug-induced platelet dysfunction on surgical bleeding.

Two hundred patients scheduled to undergo a variety of surgical and gynecologic procedures were studied to determine whether increased surgical bleeding occurred in those who had drug-induced platelet dysfunction. Twelve of 55 patients (22 percent) who had a positive drug history and abnormal platelet aggregation were judged to have excessive bleeding at surgery or postoperatively, compared with 7 of 97 patients (7 percent) with a negative drug history and normal platelet aggregation (p less than 0.02).