Early lymphopenia as a risk factor for chemotherapy-induced febrile neutropenia.
Febrile neutropenia (FN) is a frequent complication of cancer chemotherapy, which causes death in 4-21% of patients and worsens the quality of life of patients. As a simple and accurate way of identifying patients who are at risk of FN, a lymphocyte count on post-chemotherapy day 5 was suggested. To confirm the feasibility of this method and to define the incidence of FN among our own patient group, we conducted this prospective study. From September 2001 to February 2002, patients who received cytotoxic chemotherapy at Guro Hospital, Korea University, were enrolled. Blood sampling for a complete blood count was done on the starting day of chemotherapy and on day 3 and day 5 post-chemotherapy. The prospective results of the CBC were compared between the FN group and non-FN group. During the study period, 82 patients were enrolled. The male to female ratio was 52:30, and the median age was 56 years old (range: 14-78). Underlying malignancies were non-Hodgkin's lymphoma (14 patients), stomach cancer (17), breast cancer (11), NSCLC (7), hepatobiliary cancer (10), sarcoma (3), colorectal cancer (3), and others (17). The incidence of FN was 18% (15/82 patients), and ANC at the time of FN was 275 +/- 327/ micro l. Duration of fever was 3.9 +/- 3.5 days. The incidence of FN was significantly higher in patients with lymphocyte counts at day 3 < or = 500/micro l (P = 0.06), day 5 < or = 500/micro l (P = 0.023), day 3 < or = 700/micro l (P = 0.01), and day 5 < or = 700/micro l (P = 0.0001). As a result of a logistic regression test, a day-5 lymphocyte count < or = 700/ micro l was identified as an independent risk factor for FN. In conclusion, a day-5 lymphocyte count <700/micro l was a risk factor for FN. To strengthen our result, we are planning to validate in a larger patient group.
Choi
Chul Won
CW
Department of Internal Medicine, Korea University Medical Center, Seoul, Korea.
Sung
Hwa Jung
HJ
Park
Kyong Hwa
KH
Yoon
So Young
SY
Kim
Seok Jin
SJ
Oh
Sang Cheul
SC
Seo
Jae Hong
JH
Kim
Byung Soo
BS
Shin
Sang Won
SW
Kim
Yeul Hong
YH
Kim
Jun Suk
JS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D005260:Female; D005334:Fever; D006801:Humans; D015994:Incidence; D018655:Lymphocyte Count; D008231:Lymphopenia; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy; D009503:Neutropenia / Q000139:chemically induced / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors
D000970:Antineoplastic Agents