Risk assessment model for first-cycle chemotherapy-induced neutropenia in patients with solid tumours
Por:
Lopez-Pousa, A, Rifa, J, De Tejerina, AC, Gonzalez-Larriba, JL, Iglesias, C, Gasquet, JA, Carrato, A
Publicada:
1 sep 2010
Resumen:
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 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 < 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.
Filiaciones:
Lopez-Pousa, A:
Santa Creu & St Pau Hosp, Dept Med Oncol, Barcelona, Spain
Rifa, J:
Son Dureta Hosp, Dept Med Oncol, Palma de Mallorca, Spain
De Tejerina, AC:
Virgen Rocio Hosp, Dept Med Oncol, Seville, Spain
Gonzalez-Larriba, JL:
Clin San Carlos Hosp, Dept Med Oncol, Madrid, Spain
Iglesias, C:
Salutis Res SA, Dept Med, Barcelona, Spain
Gasquet, JA:
Amgen SA, Dept Med, Barcelona, Spain
Carrato, A:
Elche Univ Hosp, Dept Med Oncol, Elche, Spain
Green Published
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