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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

Pettengell, R; Bosly, A; Szucs, TD; Jackisch, C; Leonard, R; Paridaens, R; Constenla, M; Schwenkglenks, M; Impact of Neutropenia in Chemotherapy-European Study Group (INC- (2009) Multivariate analysis of febrile neutropenia occurrence in patients with non-Hodgkin lymphoma: data from the INC-EU Prospective Observational European Neutropenia Study. BRITISH JOURNAL OF HAEMATOLOGY, 144 (5). 677 - 685 (9). ISSN 0007-1048 https://doi.org/10.1111/j.1365-2141.2008.07514.x
SGUL Authors: Pettengell, Ruth

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Abstract

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.

Item Type: Article
Additional Information: PubMed ID: 19055662
Keywords: Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Antibodies, Monoclonal, Antibodies, Monoclonal, Murine-Derived, Antineoplastic Agents, Antineoplastic Combined Chemotherapy Protocols, Area Under Curve, Body Weight, Colony-Stimulating Factors, Cyclophosphamide, Doxorubicin, Europe, Female, Humans, Immunosuppressive Agents, Logistic Models, Lymphoma, Non-Hodgkin, Male, Middle Aged, Neutropenia, Prednisone, Prevalence, Prognosis, Prospective Studies, Recombinant Proteins, Risk Assessment, Vincristine, Young Adult, Science & Technology, Life Sciences & Biomedicine, Hematology, Non-Hodgkin lymphoma, neutropenia, chemotherapy, risk factors, RELATIVE DOSE INTENSITY, B-CELL LYMPHOMA, CHEMOTHERAPY-INDUCED NEUTROPENIA, COLONY-STIMULATING FACTORS, CHOP CHEMOTHERAPY, ELDERLY-PATIENTS, CANCER-PATIENTS, BREAST-CANCER, PROGNOSTIC-SIGNIFICANCE, PREDICTIVE MODEL, Non-Hodgkin lymphoma, neutropenia, chemotherapy, risk factors
SGUL Research Institute / Research Centre: Academic Structure > Institute of Medical & Biomedical Education (IMBE)
Academic Structure > Institute of Medical & Biomedical Education (IMBE) > Centre for Clinical Education (INMECE )
Journal or Publication Title: BRITISH JOURNAL OF HAEMATOLOGY
ISSN: 0007-1048
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Dates:
DateEvent
1 March 2009Published
Web of Science ID: WOS:000262826400006
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URI: http://openaccess.sgul.ac.uk/id/eprint/102375
Publisher's version: https://doi.org/10.1111/j.1365-2141.2008.07514.x

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