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>or=3, with or without body temperature>or=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<or=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.
López-Pousa
A
A
Medical Oncology Department, Santa Creu i Sant Pau Hospital, Barcelona, Spain. alopezp@santpau.es
Rifà
J
J
Casas de Tejerina
A
A
González-Larriba
J L
JL
Iglesias
C
C
Gasquet
J A
JA
Carrato
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy*; D009503:Neutropenia / Q000139:chemically induced* / Q000517:prevention & control; D009504:Neutrophils / Q000187:drug effects*; D011446:Prospective Studies; D012737:Sex Factors; D013030:Spain; D055815:Young Adult