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Risk assessment model for first‐cycle chemotherapy‐induced neutropenia in patients with solid tumours
Author(s) -
LÓPEZPOUSA A.,
RIFÀ J.,
CASAS DE TEJERINA A.,
GONZÁLEZLARRIBA J.L.,
IGLESIAS C.,
GASQUET J.A.,
CARRATO A.
Publication year - 2010
Publication title -
european journal of cancer care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.849
H-Index - 67
eISSN - 1365-2354
pISSN - 0961-5423
DOI - 10.1111/j.1365-2354.2009.01121.x
Subject(s) - medicine , neutropenia , odds ratio , chemotherapy , absolute neutrophil count , incidence (geometry) , logistic regression , prospective cohort study , surgery , physics , optics
LÓPEZ‐POUSA A., RIFÀ J., CASAS DE TEJERINA A., GONZÁLEZ‐LARRIBA J.L., IGLESIAS C., GASQUET J.A. & CARRATO A. (2010) European Journal of Cancer Care Risk assessment model for first‐cycle chemotherapy‐induced neutropenia in patients with solid tumours 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 ≥3, with or without body temperature ≥38°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 ≤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.