A general chemotherapy myelotoxicity score to predict febrile neutropenia in hematological malignancies.
BACKGROUND
Chemotherapy-induced neutropenia is the most common adverse effect of chemotherapy and is often complicated by febrile neutropenia (FN). The objective of this study is to validate a classification of aggressiveness of a chemotherapy regimen and to evaluate its usefulness in a risk prediction model of FN in patients with hematological cancer at the beginning of a chemotherapy cycle.


METHODS
Two hundred and sixty-six patients were prospectively enrolled and followed during 1053 cycles. Relevant patient informations were collected at the beginning of the first cycle and the number of days of FN were counted in the follow-up [dichotomized (no FN versus >or= 1 day of FN)].


RESULTS
Aggressive chemotherapy regimen is the major predictor of FN [odds ratio 5.2 (3.2-8.4)]. The other independent predictors are the underlying disease, an involvement of bone marrow, body surface <or= 2 m(2), a baseline monocyte count <150/microl and the interaction between the first cycle in the same treatment line and a baseline hemoglobin dosage. A rule of prediction of FN was computed with these characteristics: sensitivity 78.6%, specificity 62.3%, positive predictive value 42.7% and negative predictive value 89.1%.


CONCLUSIONS
Further studies are needed to validate this score.
Moreau
M
M
Datacentre, Institut Jules Bordet, Brussels, Belgium. michel.moreau@bordet.be
Klastersky
J
J
Schwarzbold
A
A
Muanza
F
F
Georgala
A
A
Aoun
M
M
Loizidou
A
A
Barette
M
M
Costantini
S
S
Delmelle
M
M
Dubreucq
L
L
Vekemans
M
M
Ferrant
A
A
Bron
D
D
Paesmans
M
M
D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D005334:Fever / Q000139:chemically induced* / Q000150:complications; D019337:Hematologic Neoplasms / Q000188:drug therapy*; D006801:Humans; D009503:Neutropenia / Q000139:chemically induced* / Q000150:complications; D011446:Prospective Studies; D012680:Sensitivity and Specificity
D000970:Antineoplastic Agents