Congress Abstracts 2005

79

EXPANDING APPLICATIONS OF COLONY STIMULATING FACTORS: MUCOSITIS, DIARRHEA, WOUND HEALING, AND CROHN DISEASE. Patricia Buchsel, RN, MSN, FAAN, University of Washington, School of Nursing, Seattle, WA, and Elaine DeMeyer, MSN, AOCN^®, Creative Cancer Concepts, Rockwall, TX.

Colony stimulating factors (CSF) are commonly used as supportive care agents for neutrophil recovery. Recent encouraging results suggest that CSFs may have expanding applications beyond neutrophil recovery including treatment of mucositis, diarrhea, chemotherapy extravasation ulcers, pressure sores, and chronic refractory wounds. Other patients who have shown benefit are those with gastrointestinal disorders such as Crohn disease. Oncology nurses can broaden their knowledge of new applications for proven therapies such as CSFs for the improvement of their clinical knowledge and to enhance patient education.

The purpose of this abstract is to acquaint oncology nurses with the expanding uses of CSFs in supportive care beyond neutrophil recovery and to introduce the concept of GM-CSF in new applications.

Early research with GM-CSF suggested that allogneic bone marrow transplant recipients who received GM-CSF had a 72% lower rate of mucositis than patients receiving placebo (p = 0.005). A recent study (n = 69) showed that oral mucositis lengthen hospital stays by 6 days in stem cell transplant recipients. Another study (n = 92) showed the economic burden of mucositis to be $42,749 more when compared to those without mucositis. Case studies now indicate that the use of topical or subcutaneous GM-CSF is effective in wound healing after an infection resulting from a PEG tube, in skin ulcerations in breast cancer, chemotherapy extravasation ulcers, and in healing of chronic refractory wounds in patients with sickle cell anemia. An early study in patients with Crohn disease (n = 124) demonstrated that more than 54% had improvements in debiliating symptoms.

Clinical studies and case studies show that CSFs to be effective in many adverse effects of cancer and its treatment. These conditions are managed by oncology nurses worldwide and have enormous impact on the well being of the cancer patient.

Oncology nurses have long been familiar with the supportive care rendered by CSFS. New information on the expanding uses of GM-CSF suggest that common adverse effects of cancer and its treatment such as mucositis, wound healing, and inflammatory diseases may improve the clinical and economic outcomes of debilitating adverse effects of cancer treatment such as mucositis. In many cases, CSFs are not administered in traditional dosing. Oncology nurses need to be knowledgeable about not only new applications but of new administration methods.