title: Risk factors for predicting severe neutropenia induced by amrubicin in patients with advanced lung cancer.
abstract: BACKGROUND
  Neutropenia is one of the most frequent and dose-limiting toxicities in amrubicin (AMR) therapy. However, the predictive factors for the development of severe neutropenia in AMR therapy remain unknown.
  
  
  METHODS
  The subjects were 61 advanced lung cancer patients treated with AMR monotherapy. All data were retrospectively collected from the electronic medical record system. A stepwise logistic regression analysis was performed to identify risk factors for grade 3-4 neutropenia.
  
  
  RESULTS
  Of a total 61 patients, 50 were male and 11 were female. The median dose of AMR was 35.0 mg/m(2). The incidence of grade 3-4 neutropenia during the first course was 62%. In multivariate analysis, female gender (OR = 6.68; 95% CI 1.01-134.15; p = 0.049), higher AMR doses (40 mg/m(2) or more) (OR = 5.98; 95% CI 1.77-23.74; p = 0.003), and lower hematocrit values (OR = 2.04 per 5% decrease; 95% CI 1.04-4.38; p = 0.036) were significantly associated with severe neutropenia induced by AMR.
  
  
  CONCLUSIONS
  The present results suggest that female gender, higher doses of AMR, and lower baseline hematocrit values are predictive factors associated with severe neutropenia induced by AMR in patients with advanced lung cancer. Patients who have these predictive factors should be monitored carefully and considered for early granulocyte colony-stimulating factor support.
authors.affiliation: Department of Pharmacy, Kyushu University Hospital, Fukuoka 8128582, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Watanabe
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ikesue
authors.forename: Marina
authors.initials: M
authors.lastname: Oshiro
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Nagata
authors.forename: Kazuto
authors.initials: K
authors.lastname: Mishima
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takada
authors.forename: Kimitaka
authors.initials: K
authors.lastname: Suetsugu
authors.forename: Masanori
authors.initials: M
authors.lastname: Sueyasu
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Egashira
authors.forename: Taishi
authors.initials: T
authors.lastname: Harada
authors.forename: Koichi
authors.initials: K
authors.lastname: Takayama
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Nakanishi
authors.forename: Ryozo
authors.initials: R
authors.lastname: Oishi
mesh_terms: D000328:Adult; D000368:Aged; D018943:Anthracyclines / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D057286:Electronic Health Records; D005260:Female; D006400:Hematocrit; D006801:Humans; D016015:Logistic Models; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009503:Neutropenia / Q000139:chemically induced* / Q000453:epidemiology / Q000503:physiopathology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors
chemical_list: D018943:Anthracyclines; D000970:Antineoplastic Agents; C055866:amrubicin