PACULit Daily Literature Update: Long acting lipegfilgrastim and antimicrobials as vigorous primary prophylaxis in bendamustine treated patients with indolent B cell non Hodgkin lymphoma a multicentric real life experience Quiz

Mr. Johnson is a 72-year-old male diagnosed with indolent B-cell non-Hodgkin lymphoma starting frontline bendamustine-rituximab chemotherapy. His medical history includes well-controlled hypertension and no known drug allergies. Current medications include lisinopril 10 mg daily and aspirin 81 mg daily. He is concerned about infection risk during chemotherapy and asks about strategies to prevent febrile neutropenia and treatment delays.

Question: Based on recent evidence from Giordano et al., which prophylactic regimen should the pharmacist recommend to minimize febrile neutropenia and chemotherapy disruptions in Mr. Johnson?

Mrs. Lee is a 65-year-old female receiving bendamustine-rituximab chemotherapy for indolent B-cell NHL. She has been receiving lipegfilgrastim 6 mg subcutaneously on day 5 of each cycle as prophylaxis. After her second cycle, she reports moderate bone pain interfering with sleep. She is hesitant to continue prophylaxis due to this side effect.

Question: What is the most appropriate pharmacist recommendation to manage Mrs. Lee’s lipegfilgrastim-associated bone pain while maintaining prophylaxis?

Mr. Smith, a 70-year-old man with indolent B-cell NHL, is completing his sixth and final cycle of bendamustine-rituximab chemotherapy. He has been on trimethoprim-sulfamethoxazole and acyclovir prophylaxis during treatment. He asks how long he should continue these antimicrobial agents after chemotherapy ends.

Question: According to the findings by Giordano et al., what is the recommended duration for continuing antimicrobial prophylaxis after the last chemotherapy cycle to reduce infection risk?