title: Can first cycle CBCs predict older patients at very low risk of neutropenia during further chemotherapy?
abstract: Elderly cancer patients with normal complete blood cell counts (CBCs) during the first course of (some types of) chemotherapy might be unlikely to experience grade 4 neutropenia during subsequent cycles. In this case, further weekly CBCs might be avoided. We used data of 223 cancer patients aged 70+ who were included in the CRASH (Chemotherapy Risk Assessment Score for High-age patients) trial between 2003 and 2007 in 7 cancer practices in the US. First cycle CBC values were compared to subsequent cycles. MAX2-score was used as a measure for toxicity of the chemotherapy regimen. Sixty-two patients (28%) experienced grade 4 neutropenia during subsequent cycles. Among patients who received chemotherapy with a MAX2-score lower than 0.20, only 4.6% of those without neutropenia during the first cycle experienced grade 4 neutropenia during subsequent cycles. Weekly CBC might be avoided in these patients receiving chemotherapy. Future prospective studies should confirm these results.
authors.affiliation: Eindhoven Cancer Registry, Department of Research, Eindhoven, The Netherlands. research@ikz.nl
authors.forename: Maryska L G
authors.initials: ML
authors.lastname: Janssen-Heijnen
authors.forename: Martine
authors.initials: M
authors.lastname: Extermann
authors.forename: Ivette E
authors.initials: IE
authors.lastname: Boler
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001772:Blood Cell Count; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D009503:Neutropenia / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D011237:Predictive Value of Tests; D018570:Risk Assessment