Predicting individual risk of neutropenic complications in patients receiving cancer chemotherapy.


Journal Article

BACKGROUND: A prospective cohort study was undertaken to develop and validate a risk model for neutropenic complications in cancer patients receiving chemotherapy. METHODS: The study population consisted of 3760 patients with common solid tumors or malignant lymphoma who were beginning a new chemotherapy regimen at 115 practice sites throughout the United States. A regression model for neutropenic complications was developed and then validated by using a random split-sample selection process. RESULTS: No significant differences in the derivation and validation populations were observed. The risk of neutropenic complications was greatest in cycle 1 with no significant difference in predicted risk between the 2 cohorts in univariate analysis. After adjustment for cancer type and age, major independent risk factors in multivariate analysis included: prior chemotherapy, abnormal hepatic and renal function, low white blood count, chemotherapy and planned delivery ≥85%. At a predicted risk cutpoint of 10%, model test performance included: sensitivity 90%, specificity 59%, and predictive value positive and negative of 34% and 96%, respectively. Further analysis confirmed model discrimination for risk of febrile neutropenia over multiple chemotherapy cycles. CONCLUSIONS: A risk model for neutropenic complications was developed and validated in a large prospective cohort of patients who were beginning cancer chemotherapy that may guide the effective and cost-effective use of available supportive care.

Full Text

Duke Authors

Cited Authors

  • Lyman, GH; Kuderer, NM; Crawford, J; Wolff, DA; Culakova, E; Poniewierski, MS; Dale, DC

Published Date

  • May 1, 2011

Published In

Volume / Issue

  • 117 / 9

Start / End Page

  • 1917 - 1927

PubMed ID

  • 21509769

Pubmed Central ID

  • 21509769

International Standard Serial Number (ISSN)

  • 0008-543X

Digital Object Identifier (DOI)

  • 10.1002/cncr.25691


  • eng

Conference Location

  • United States