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M9471079.TXT
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1994-08-09
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Document 1079
DOCN M9471079
TI Early lymphopenia is a risk factor for chemotherapy induced febrile
neutropenia: description of a prognostic index (Meeting abstract).
DT 9409
AU Blay J-Y; Anglaret B; Lasset C; Freyer G; Chauvin F; Biron P; Center L.
Berard (CLB), 28 rue Laennec, 69008 Lyon, France
SO Proc Annu Meet Am Soc Clin Oncol; 13:A1506 1994. Unique Identifier :
AIDSLINE ICDB/94601499
AB Febrile neutropenia (FN) is a frequent life threatening complication of
cytotoxic chemotherapy (CT) whose incidence depends on the doses and
drugs and individual factors. Here, we have investigated risk factors
(RF) for FN in a retrospective series of 112 cancer patients (pts)
treated at the CLB in 1992. Pts were over 18 years, HIV negative, not
treated concomitantly with cytokines, and received conventional (ie,
without stem cell support) CT. Univariate analysis showed that high risk
CT (ie, including 2 or more of these criteria per course: ADM greater
than 50 mg/m2, CDDP greater than 100 mg/m2, CPM greater than 1 g/m2,
ifosfamide greater than 5 g/m2, VP16 greater than 350 mg/m2, ARA-C
greater than 1 g/m2) and d5 lymphocyte (Ly) counts less than 700/uL, but
not d1 or d5 PMN counts nor d1 Ly counts, correlated to the risk of FN.
A multivariate logistic regression was performed to identify independent
RF for FN among the following parameters: age greater than 60, PS, high
risk CT, metastases (yes vs no), bone marrow involvement, number of
previous courses of CT, number of relapses, d1 and d5 PMN counts (less
than vs greater than 1500/uL), d1 and d5 Ly counts (less than vs greater
than 700/uL). Only high risk CT and d5 Ly were independent RF (beta:
-1.99+/-0.57 and -2.06+/-0.56 respectively). The observed incidence of
FN in patients with none, one and two of these 2 RF was 1/44 (2%), 12/42
(28%) and 17/26 (65%). This model was then tested on a distinct
prospective series of 116 pts treated between April and June 1993 in the
CLB. The observed incidence of pts with none, one and 2 of these 2 RF
was respectively 2/56 (3%), 11/50 (22%) and 13/20 (65%) respectively,
confirming the value of the model. These results indicate that early
lymphopenia after cytotoxic chemotherapy is a risk factor for FN and
describe a predictive model for FN with potential clinical value.
DE Antineoplastic Agents/*ADVERSE EFFECTS Cisplatin/ADVERSE EFFECTS
Cyclophosphamide/ADVERSE EFFECTS Cytarabine/ADVERSE EFFECTS
Doxorubicin/ADVERSE EFFECTS Etoposide/ADVERSE EFFECTS Fever/*ETIOLOGY
Human Ifosfamide/ADVERSE EFFECTS Lymphopenia/CHEMICALLY
INDUCED/*PHYSIOPATHOLOGY Neutropenia/*CHEMICALLY INDUCED Prognosis
Retrospective Studies Risk Factors MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).