Annals of Oncology Advance Access originally published online on January 12, 2009
Annals of Oncology 2009 20(3):513-519; doi:10.1093/annonc/mdn655
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hematologic malignancies |
A general chemotherapy myelotoxicity score to predict febrile neutropenia in hematological malignancies
1 Datacentre, Institut Jules Bordet, Brussels, Belgium
2 Service of Internal medicine, Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil
3 Service d'Hématologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium
* Correspondence to: Dr M. Moreau, Institut Jules Bordet, Rue Héger Bordet 1, 1000 Brussels. Tel: +32 2/5413056; Fax: +32 2/5413397 or +32 2/5386551; E-mail: michel.moreau{at}bordet.be
Background: Chemotherapy-induced neutropenia is the most common adverse effect of chemotherapy and is often complicated by febrile neutropenia (FN). The objective of this study is to validate a classification of aggressiveness of a chemotherapy regimen and to evaluate its usefulness in a risk prediction model of FN in patients with hematological cancer at the beginning of a chemotherapy cycle.
Patients and methods: Two hundred and sixty-six patients were prospectively enrolled and followed during 1053 cycles. Relevant patient informations were collected at the beginning of the first cycle and the number of days of FN were counted in the follow-up [dichotomized (no FN versus 
1 day of FN)].
Results: Aggressive chemotherapy regimen is the major predictor of FN [odds ratio 5.2 (3.2–8.4)]. The other independent predictors are the underlying disease, an involvement of bone marrow, body surface 
2 m2, a baseline monocyte count <150/µl and the interaction between the first cycle in the same treatment line and a baseline hemoglobin dosage. A rule of prediction of FN was computed with these characteristics: sensitivity 78.6%, specificity 62.3%, positive predictive value 42.7% and negative predictive value 89.1%.
Conclusion: Further studies are needed to validate this score.
Key words: chemotherapy, febrile neutropenia, hematological malignancies, myelotoxicity score, prediction, risk model
Received for publication April 8, 2008. Revision received August 20, 2008. Accepted for publication September 3, 2008.