Validation of a predictive model that identifies patients at high risk of developing febrile neutropaenia following chemotherapy for breast cancer

被引:33
作者
Jenkins, P. [1 ]
Scaife, J. [1 ]
Freeman, S. [2 ]
机构
[1] Cheltenham Gen Hosp, Gloucestershire Oncol Ctr, Cheltenham GL53 7AN, Glos, England
[2] Univ Birmingham, Sch Med, Dept Haematol, Birmingham B15 2TT, W Midlands, England
关键词
chemotherapy; febrile neutropaenia; risk models; COLONY-STIMULATING FACTOR; CELL LUNG-CANCER; ADJUVANT DOCETAXEL; DOUBLE-BLIND; PEGFILGRASTIM; PROPHYLAXIS; MULTICENTER; GUIDELINES; MYELOSUPPRESSION; LYMPHOPENIA;
D O I
10.1093/annonc/mdr493
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
We have previously developed a predictive model that identifies patients at increased risk of febrile neutropaenia (FN) following chemotherapy, based on pretreatment haematological indices. This study was designed to validate our earlier findings in a separate cohort of patients undergoing more myelosuppressive chemotherapy supported by growth factors. We conducted a retrospective analysis of 263 patients who had been treated with adjuvant docetaxel, adriamycin and cyclophosphamide (TAC) chemotherapy for breast cancer. All patients received prophylactic pegfilgrastim and the majority also received prophylactic antibiotics. Thirty-one patients (12%) developed FN. Using our previous model, patients in the highest risk group (pretreatment absolute neutrophil count < 3.1 x 10(9)/l and absolute lymphocyte count < 1.5 x 10(9)/l) comprised 8% of the total population and had a 33% risk of developing FN. Compared with the rest of the cohort, this group had a 3.4-fold increased risk of developing FN (P = 0.001) and a 5.2-fold increased risk of cycle 1 FN (P < 0.001). A simple model based on pretreatment differential white blood cell count can be applied to pegfilgrastim-supported patients to identify those who are at higher risk of FN.
引用
收藏
页码:1766 / 1771
页数:6
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