title: Greater physical and psychological symptom burden in patients with grade 3/4 chemotherapy-induced neutropenia.
abstract: BACKGROUND
  Neutropenia is a common toxicity caused by chemotherapy that can lead to febrile neutropenia, infection, and dose reductions or delays that can diminish the efficacy of treatment. The relationship between chemotherapy-induced neutropenia and symptom burden is less well known. Recent data show a trend toward a greater incidence, duration, and severity of other toxicities of chemotherapy in patients with grade 4 neutropenia.
  
  
  METHODS
  This retrospective study examined the relationship between symptom burden and neutropenia in the first cycle of chemotherapy, using the Cancer Care Monitor (CCM) to evaluate symptom burden in 5 domains: Physical Symptoms, Side Effects, Distress, Despair, and Neutropenia Index. Data were collected from the medical records of 51 adult patients with cancer who had been treated with standard 21-day regimens without granulocyte colony-stimulating factor support. Patients had been assessed before treatment and at midcycle (days 6-14) for complete blood cell count and symptom burden.
  
  
  RESULTS
  The symptom burden in all 5 CCM domains was greater in patients with grade 3 (n = 8) or grade 4 (n = 16) neutropenia at midcycle than in patients with grade 0-2 neutropenia. Age, chemotherapy regimen or dose, and day of midcycle assessment were not significantly correlated with the severity of symptoms.
  
  
  CONCLUSIONS
  Understanding the relationship between symptom burden and chemotherapy-induced neutropenia can lead to more appropriate use of supportive care in patients treated with chemotherapy.
authors.affiliation: Supportive Oncology Services and Accelerated Community Oncology Research Network and the West Clinic, Memphis, TN.
authors.forename: Barry V
authors.initials: BV
authors.lastname: Fortner
authors.forename: Arthur C
authors.initials: AC
authors.lastname: Houts