Prognostic evaluation of febrile neutropenia in apparently stable adult cancer patients.

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.

• 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)

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