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Predictors of severe and febrile neutropenia during primary chemotherapy for ovarian cancer.

Publication ,  Journal Article
Laskey, RA; Poniewierski, MS; Lopez, MA; Hanna, RK; Secord, AA; Gehrig, PA; Lyman, GH; Havrilesky, LJ
Published in: Gynecol Oncol
June 2012

OBJECTIVE: To identify factors that increase the risk of neutropenic events in women with advanced ovarian carcinoma receiving initial chemotherapy. METHODS: Multi-center retrospective study of women with FIGO stage III-IV epithelial ovarian cancer treated postoperatively with multi-agent intravenous chemotherapy from 1995 to 2008. Outcomes were severe (SN; absolute neutrophil count [ANC]<500/mm(3)) and febrile neutropenia (FN; ANC<1000/mm(3) and temperature>38.1°C). Cumulative risk of neutropenic events was estimated by Kaplan Meier method. Multivariate analysis was by Cox proportional hazard regression. RESULTS: Three hundred twenty-six patients met inclusion criteria. There were 251 SN events among 140 (43%) patients and 24 FN events among 22 (7%) patients. Univariate predictors of SN were body surface area<2.0m(2) (p=0.03), body mass index (BMI)<30 kg/m(2) (p<0.01), Caucasian race (p<0.01), treatment on research protocols (p<0.01), non-carboplatin-containing regimens (p<0.01), and planned relative dose intensity (RDI)>85% of standard (p=0.02). Women over age 60 were more likely to develop FN (p=0.05). Multivariate predictors of SN were treatment on research protocols (hazard ratio [HR] 1.93; p<0.01), Caucasian race (HR 2.13; p=0.01), and planned RDI>85% (HR 1.69; p=0.05); predictors of FN were age>60 (HR 2.84; p=0.05) and non-carboplatin containing regimens (HR 4.06; p<0.01). CONCLUSION: While SN is fairly common, FN occurs infrequently in women with EOC undergoing taxane and platin-based chemotherapy and primary prophylactic growth factor support is not indicated. However, women older than 60 years of age receiving non-carboplatin containing regimens are at higher risk for FN and warrant closer surveillance.

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Published In

Gynecol Oncol

DOI

EISSN

1095-6859

Publication Date

June 2012

Volume

125

Issue

3

Start / End Page

625 / 630

Location

United States

Related Subject Headings

  • Risk Factors
  • Retrospective Studies
  • Predictive Value of Tests
  • Ovarian Neoplasms
  • Oncology & Carcinogenesis
  • Neutropenia
  • Neoplasm Staging
  • Middle Aged
  • Humans
  • Granulocyte Colony-Stimulating Factor
 

Citation

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Laskey, R. A., Poniewierski, M. S., Lopez, M. A., Hanna, R. K., Secord, A. A., Gehrig, P. A., … Havrilesky, L. J. (2012). Predictors of severe and febrile neutropenia during primary chemotherapy for ovarian cancer. Gynecol Oncol, 125(3), 625–630. https://doi.org/10.1016/j.ygyno.2012.03.015
Laskey, Robin A., Marek S. Poniewierski, Micael A. Lopez, Rabbie K. Hanna, Angeles Alvarez Secord, Paola A. Gehrig, Gary H. Lyman, and Laura J. Havrilesky. “Predictors of severe and febrile neutropenia during primary chemotherapy for ovarian cancer.Gynecol Oncol 125, no. 3 (June 2012): 625–30. https://doi.org/10.1016/j.ygyno.2012.03.015.
Laskey RA, Poniewierski MS, Lopez MA, Hanna RK, Secord AA, Gehrig PA, et al. Predictors of severe and febrile neutropenia during primary chemotherapy for ovarian cancer. Gynecol Oncol. 2012 Jun;125(3):625–30.
Laskey, Robin A., et al. “Predictors of severe and febrile neutropenia during primary chemotherapy for ovarian cancer.Gynecol Oncol, vol. 125, no. 3, June 2012, pp. 625–30. Pubmed, doi:10.1016/j.ygyno.2012.03.015.
Laskey RA, Poniewierski MS, Lopez MA, Hanna RK, Secord AA, Gehrig PA, Lyman GH, Havrilesky LJ. Predictors of severe and febrile neutropenia during primary chemotherapy for ovarian cancer. Gynecol Oncol. 2012 Jun;125(3):625–630.
Journal cover image

Published In

Gynecol Oncol

DOI

EISSN

1095-6859

Publication Date

June 2012

Volume

125

Issue

3

Start / End Page

625 / 630

Location

United States

Related Subject Headings

  • Risk Factors
  • Retrospective Studies
  • Predictive Value of Tests
  • Ovarian Neoplasms
  • Oncology & Carcinogenesis
  • Neutropenia
  • Neoplasm Staging
  • Middle Aged
  • Humans
  • Granulocyte Colony-Stimulating Factor