Neutropenia occurrence and predictors of reduced chemotherapy delivery: results from the INC-EU prospective observational European neutropenia study |
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Authors: | Ruth?Pettengell Matthias?Schwenkglenks Robert?Leonard André?Bosly Robert?Paridaens Manuel?Constenla Thomas?D?Szucs Christian?Jackisch Impact of Neutropenia in Chemotherapy—European Study Group |
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Institution: | Ruth Pettengell, Matthias Schwenkglenks, Robert Leonard, André Bosly, Robert Paridaens, Manuel Constenla, Thomas D. Szucs, Christian Jackisch and Impact of Neutropenia in Chemotherapy—European Study Group (INC-EU) |
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Abstract: | Goals of work Neutropenia is a life-threatening, dose-limiting toxicity of many chemotherapy regimens. The goals of this study were to assess
the incidence and risk of chemotherapy-induced neutropenia, febrile neutropenia (FN) and dose limitations in breast cancer
and lymphoma patients undergoing chemotherapy in Europe.
Patients and methods Four hundred forty-four breast cancer and 305 lymphoma patients undergoing chemotherapy at 66 practices in five European countries
participated in this prospective, observational study. Predictors of impaired chemotherapy delivery were investigated using
a logistic regression model.
Main results In breast cancer, FN incidence was low (6%); however, grade 4 neutropenia was frequent (34%). Lymphoma patients experienced
higher incidences of FN (non-Hodgkin lymphoma (NHL) 22%; Hodgkin lymphoma (HL) 15%) and grade 4 neutropenia (NHL 54%; HL 40%).
For both diseases, FN and grade 4 neutropenia were associated with low relative dose intensity (RDI). Multivariate regression
models indicated that first cycle FN, age ≥ 65 years and Eastern Co-operative Oncology Group > 1 were associated with low
RDI in breast cancer and lymphoma, while colony-stimulating factor (CSF) primary prophylaxis appeared to be protective in
lymphoma only. Primary CSF prophylaxis was provided to 9% of breast cancer, 28% of NHL and 19% of HL patients.
Conclusions Neutropenia and low RDI remain serious problems in both breast cancer and lymphoma populations undergoing chemotherapy. Several
risk factors which can trigger reduced chemotherapy delivery were identified. These results can support physicians in identifying
patients most at risk of receiving impaired chemotherapy delivery who would benefit from suitable preventive measures. |
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Keywords: | Breast cancer Lymphoma Neutropenia Risk model Relative dose intensity |
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