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Multivariate analysis of febrile neutropenia occurrence in patients with non-Hodgkin lymphoma : data from the INC-EU Prospective Observational European Neutropenia Study
JournalArticle (Originalarbeit in einer wissenschaftlichen Zeitschrift)
ID
1193154
Author(s)
Pettengell, Ruth; Bosly, André; Szucs, Thomas D; Jackisch, Christian; Leonard, Robert; Paridaens, Robert; Constenla, Manuel; Schwenkglenks, Matthias; Impact of Neutropenia in Chemotherapy-European Study Group (INC-EU)
Multivariate analysis of febrile neutropenia occurrence in patients with non-Hodgkin lymphoma : data from the INC-EU Prospective Observational European Neutropenia Study
Journal
British journal of haematology : the official journal of the British Society for Haematology and the European Haematology Association
Myelosuppression, particularly febrile neutropenia (FN), are serious dose-limiting toxicities that occur frequently during the first cycle of chemotherapy. Identifying patients most at risk of developing FN might help physicians to target prophylactic treatment with colony-stimulating factor (CSF), in order to decrease the incidence, or duration, of myelosuppression and facilitate delivery of chemotherapy as planned. We present a risk model for FN occurrence in the first cycle of chemotherapy, based on a subgroup of 240 patients with non-Hodgkin lymphoma (NHL) enroled in our European prospective observational study. Eligible patients had an International Prognostic Index of 0-3, and were scheduled to receive a new myelosuppressive chemotherapy regimen with at least four cycles. Clinically relevant factors significantly associated with cycle 1 FN were older age, increasing planned cyclophosphamide dose, a history of previous chemotherapy, a history of recent infection, and low baseline albumin (<35 g/l). Prophylactic CSF use and higher weight were associated with a significant protective effect. The model had high sensitivity (81%) and specificity (80%). Our model, together with treatment guidelines, may rationalise the clinical decision of whether to support patients with CSF primary prophylaxis based on their risk factor profile. Further validation is required.
