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Multicenter Study
. 2010 Sep;19(5):648-55.
doi: 10.1111/j.1365-2354.2009.01121.x. Epub 2010 Jan 19.

Risk assessment model for first-cycle chemotherapy-induced neutropenia in patients with solid tumours

A López-Pousa  1 , J Rifà, A Casas de Tejerina, J L González-Larriba, C Iglesias, J A Gasquet, A Carrato; DELFOS Study Group
Affiliations
Free PMC article
Multicenter Study

Risk assessment model for first-cycle chemotherapy-induced neutropenia in patients with solid tumours

A López-Pousa et al. Eur J Cancer Care (Engl). 2010 Sep.
Free PMC article

Abstract

Chemotherapy-induced neutropenia, the major dose-limiting toxicity of chemotherapy, is directly associated with concomitant morbidity, mortality and health-care costs. The use of prophylactic granulocyte colony-stimulating factors may reduce the incidence and duration of chemotherapy-induced neutropenia, and is recommended in high-risk patients. The objective of this study was to develop a model to predict first-cycle chemotherapy-induced neutropenia (defined as neutropenia grade>or=3, with or without body temperature>or=38 degrees C) in patients with solid tumours. A total of 1194 patients [56% women; mean age 58+/-12 years; 94% Eastern Cooperative Oncology Group (ECOG) status<or=1] with solid tumours were included in a multi-centre non-interventional prospective cohort study. A predictive logistic regression model was developed. Several factors were found to influence chemotherapy-induced neutropenia. Higher ECOG status values increased toxicity (ECOG 2 vs. 0, P=0.003; odds ratio 3.12), whereas baseline lymphocyte (P=0.011; odds ratio 0.67) and neutrophil counts (P=0.026; odds ratio 0.90) were inversely related to neutropenia occurrence. Sex and treatment intention also significantly influenced chemotherapy-induced neutropenia (P=0.012). The sensitivity and specificity of the model were 63% and 67% respectively, and the positive and negative predictive values were 17% and 94% respectively. Once validated, this model should be a useful tool for clinical decision making.

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Figures

Figure 2
Figure 2
Logistic regression model equation for the prediction of first-cycle chemotherapy-induced neutropenia. Sex (1), male; Lym, baseline lymphocyte count; TI (1), treatment intention: radical adjuvant; TI (2), treatment intention: radical neo-adjuvant; TI (3), treatment intention: radical curative; ECOG (1), 1; ECOG (2), 2; Neutrop, baseline neutrophil count. ECOG, Eastern Cooperative Oncology Group.
Figure 1
Figure 1
Determining model sensitivity and specificity with the receiver operating characteristic curve (ROC).
See this image and copyright information in PMC

References

    1. Aapro MS, Cameron DA, Pettengell R, Bohlius J, Crawford J, Ellis M, Kearney N, Lyman GH, Tjan-Heijnen VC, Walewski J, Weber DC, Zielinski C. EORTC guidelines for the use of granulocyte-colony stimulating factor to reduce the incidence of chemotherapy-induced febrile neutropenia in adult patients with lymphomas and solid tumours. European Journal of Cancer. 2006;42:2433–2453. - PubMed
    1. Aslani A, Smith RC, Allen BJ, Pavlakis N, Levi JA. The predictive value of body protein for chemotherapy-induced toxicity. Cancer. 2000;88:796–803. - PubMed
    1. Blay JY, Chauvin F, Le Cesne A, Anglaret B, Bouhour D, Lasset C, Freyer G, Philip T, Biron P. Early lymphopenia after cytotoxic chemotherapy as a risk factor for febrile neutropenia. Journal of Clinical Oncology. 1996;14:636–643. - PubMed
    1. Bonadonna G, Valagussa P, Moliterni A, Zambetti M, Brambilla C. Adjuvant cyclophosphamide, methotrexate, and fluorouracil in node-positive breast cancer: the results of 20 years of follow-up. The New England Journal of Medicine. 1995;332:901–906. - PubMed
    1. Caggiano V, Weiss RV, Rickert TS, Linde-Zwirble WT. Incidence, cost, and mortality of neutropenia hospitalization associated with chemotherapy. Cancer. 2005;103:1916–1924. - PubMed

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