Abstract | UNLABELLED: BACKGROUND: Predictive models to identify low-risk febrile neutropenia (FN) have been developed with heterogeneous samples, which included stable and unstable patients, solid tumours, acute leukaemia and bone marrow transplantation. These models fail to recognise 5-15% of cases with unexpected complications, and literature specifically addressing apparently stable patients (ASPs) is scarce. METHODS: We reviewed 861 episodes of FN in outpatients with solid tumours, including 692 (80%) episodes with apparent clinical stability. We aimed to investigate the prognosis of this latter group and explore the possibility of stratifying it according to the presenting features. A case-control study was performed and the MASCC index was evaluated. RESULTS: The rates of complications and bacteraemia in ASPs were 7.3% and 6.2%, respectively. The MASCC index yielded a low sensitivity to detect complications (36%). Prognostic factors were identified: ECOG performance status ≥2, chronic bronchitis, chronic heart failure, stomatitis NCI grade ≥2, monocytes <200 mm(-3) and stress hyperglycaemia. CONCLUSION: A very simple assessment is useful to classify the patients with FN according to the risk of complications. A few additional variables may predict the clinical course of the patients. We additionally show that the MASCC index applied to this specific group has a low sensitivity to predict complications.
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Authors | A Carmona-Bayonas, J Gómez, E González-Billalabeitia, M Canteras, A Navarrete, M L Gonzálvez, V Vicente, F Ayala de la Peña |
Journal | British journal of cancer
(Br J Cancer)
Vol. 105
Issue 5
Pg. 612-7
(Aug 23 2011)
ISSN: 1532-1827 [Electronic] England |
PMID | 21811253
(Publication Type: Evaluation Study, Journal Article)
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Topics |
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Case-Control Studies
- Disease Progression
- Female
- Fever
(complications, diagnosis, etiology)
- Humans
- Male
- Middle Aged
- Neoplasms
(complications, diagnosis)
- Neutropenia
(complications, diagnosis, etiology)
- Prognosis
- Retrospective Studies
- Sensitivity and Specificity
- Young Adult
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