Risk factors for chemotherapy-induced neutropenia occurrence in breast cancer patients: data from the INC-EU Prospective Observational European Neutropenia Study.

Abstract

BACKGROUND:

Chemotherapy-induced neutropenia (CIN) places patients at risk of life-threatening infections. While reduction of chemotherapy dose or delay of the subsequent treatment cycle and, consequently, reduction of relative dose intensity (RDI) may limit myelotoxicity, these actions can also impact adversely on treatment outcome and should be avoided in adjuvant settings.

PATIENTS AND METHODS:

Based on data from 444 breast cancer patients in the INC-EU Prospective Observational European Neutropenia Study, we have evaluated patient-specific and treatment-specific factors that impact on the incidence of grade 4 CIN (absolute neutrophil count <0.5 × 10(9)/L), either during the first or in any cycle of (neo)adjuvant chemotherapy, across a range of regimens and doses.

RESULTS:

Using multivariate logistic regression analysis, risk factors for grade 4 CIN were identified as older age, lower weight, higher planned dose intensity of doxorubicin, epirubicin, or docetaxel, higher number of planned cycles, vascular comorbidity, lower baseline white blood cell count, and higher baseline bilirubin. Use of colony-stimulating factor before a neutropenic event occurred, dose delays, and dose reductions were protective against grade 4 CIN.

CONCLUSIONS:

By identifying risk factors for grade 4 CIN, CSF prophylaxis may be appropriately targeted to prevent low RDI in patients treated with curative intent.

• Authors: Matthias Schwenkglenks, Ruth Pettengell, Christian Jackisch, Robert Paridaens, Manuel Constenla, André Bosly, Thomas D Szucs, Robert Leonard
• Journal: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer (Support Care Cancer) Vol. 19 Issue 4 Pg. 483-90 (Apr 2011) ISSN: 1433-7339 [Electronic] Germany
• PMID: 20306092 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antineoplastic Agents

Topics

• Adult
• Age Factors
• Aged
• Aged, 80 and over
• Antineoplastic Agents (administration & dosage, adverse effects, therapeutic use)
• Body Weight
• Breast Neoplasms (drug therapy)
• Chemotherapy, Adjuvant (adverse effects, methods)
• Dose-Response Relationship, Drug
• Female
• Humans
• Incidence
• Logistic Models
• Middle Aged
• Multivariate Analysis
• Neoadjuvant Therapy (adverse effects, methods)
• Neutropenia (chemically induced, epidemiology, etiology)
• Prospective Studies
• Risk Factors