title: A prospectively validated nomogram for predicting the risk of chemotherapy-induced febrile neutropenia: a multicenter study.
abstract: OBJECTIVE
  There is clinical need to predict risk of febrile neutropenia before a specific cycle of chemotherapy in cancer patients.
  
  
  METHODS
  Data on 3882 chemotherapy cycles in 1089 consecutive patients with lung, breast, and colon cancer from four teaching hospitals were used to construct a predictive model for febrile neutropenia. A final nomogram derived from the multivariate predictive model was prospectively confirmed in a second cohort of 960 consecutive cases and 1444 cycles.
  
  
  RESULTS
  The following factors were used to construct the nomogram: previous history of febrile neutropenia, pre-cycle lymphocyte count, type of cancer, cycle of current chemotherapy, and patient age. The predictive model had a concordance index of 0.95 (95 % confidence interval (CI) = 0.91-0.99) in the derivation cohort and 0.85 (95 % CI = 0.80-0.91) in the external validation cohort. A threshold of 15 % for the risk of febrile neutropenia in the derivation cohort was associated with a sensitivity of 0.76 and specificity of 0.98. These figures were 1.00 and 0.49 in the validation cohort if a risk threshold of 50 % was chosen.
  
  
  CONCLUSIONS
  This nomogram is helpful in the prediction of febrile neutropenia after chemotherapy in patients with lung, breast, and colon cancer. Usage of this nomogram may help decrease the morbidity and mortality associated with febrile neutropenia and deserves further validation.
authors.affiliation: Department of Medical Oncology, Faculty of Medicine, Akdeniz University, 07070, Antalya, Turkey, hbozcuk@gmail.com.
authors.forename: H
authors.initials: H
authors.lastname: Bozcuk
authors.forename: M
authors.initials: M
authors.lastname: Yıldız
authors.forename: M
authors.initials: M
authors.lastname: Artaç
authors.forename: M
authors.initials: M
authors.lastname: Kocer
authors.forename: Ç
authors.initials: Ç
authors.lastname: Kaya
authors.forename: E
authors.initials: E
authors.lastname: Ulukal
authors.forename: S
authors.initials: S
authors.lastname: Ay
authors.forename: M P
authors.initials: MP
authors.lastname: Kılıç
authors.forename: E H
authors.initials: EH
authors.lastname: Şimşek
authors.forename: P
authors.initials: P
authors.lastname: Kılıçkaya
authors.forename: S
authors.initials: S
authors.lastname: Uçar
authors.forename: H S
authors.initials: HS
authors.lastname: Coskun
authors.forename: B
authors.initials: B
authors.lastname: Savas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy; D064146:Chemotherapy-Induced Febrile Neutropenia / Q000453:epidemiology*; D003110:Colonic Neoplasms / Q000188:drug therapy; D003627:Data Interpretation, Statistical; D005260:Female; D005334:Fever / Q000139:chemically induced*; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D049451:Nomograms; D011446:Prospective Studies; D012306:Risk; D012307:Risk Factors
chemical_list: D000970:Antineoplastic Agents