Development and validation of a prediction model for the risk of developing febrile neutropenia in the first cycle of chemotherapy among elderly patients with breast, lung, colorectal, and prostate cancer.

Purpose: Current guidelines recommend prophylactic use of granulocyte-colony stimulating factors (G-CSF) when febrile neutropenia (FN) risk is greater than 20%. Advanced age is a risk factor for FN; however, little is known about the impact of other factors on the incidence of FN in an older populat...

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Publicado en:Supportive Care in Cancer Vol. 19; no. 3; pp. 333 - 342
Autores principales: Hosmer W, Malin J, Wong M, Hosmer, Wylie, Malin, Jennifer, Wong, Mitchell
Formato: research Journal Article
Publicado: Springer Nature Mar2011
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2011
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      pub: Springer Nature
      place: New York, New York
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        atl: Development and validation of a prediction model for the risk of developing febrile neutropenia in the first cycle of chemotherapy among elderly patients with breast, lung, colorectal, and prostate cancer.
      aug:
        au:
          Hosmer W
          Malin J
          Wong M
          Hosmer, Wylie
          Malin, Jennifer
          Wong, Mitchell
        affil: David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
      sug:
        subj:
          Antineoplastic Agents Adverse Effects
          Fever Chemically Induced
          Models, Biological
          Neutropenia Chemically Induced
          Febrile Neutropenia
          Aged
          Aged, 80 and Over
          Antineoplastic Agents Therapeutic Use
          Female
          Fever Prevention and Control
          Forecasting
          Granulocyte Colony-Stimulating Factor Therapeutic Use
          Human
          Male
          Multivariate Analysis
          Neoplasm Staging
          Neoplasms Drug Therapy
          Neoplasms Pathology
          Neutropenia Prevention and Control
          Practice Guidelines
          Risk Factors
          Registries, Disease
          Aged: 65+ years
          Aged, 80 & over
          Female
          Male
      ab: Purpose: Current guidelines recommend prophylactic use of granulocyte-colony stimulating factors (G-CSF) when febrile neutropenia (FN) risk is greater than 20%. Advanced age is a risk factor for FN; however, little is known about the impact of other factors on the incidence of FN in an older population.Patients and Methods: We analyzed SEER-Medicare data (1994-2005) to develop and validate a prediction model for hospitalization with fever, infection, or neutropenia occurring after chemotherapy initiation for patients with breast, colorectal, prostate, and lung cancer.Results: In multivariate analysis (N = 58,053) independent predictors of FN included advanced stage at diagnosis [stage 2 (OR 1.29; 95% CI: 1.09-1.53), stage 3 (1.38; 95% CI: 1.19-1.60), and stage 4 (1.57; 95% CI: 1.35-1.83)], number of associated comorbid conditions [one condition (1.13; 95% CI: 1.02-1.28), two conditions (1.39; 95% CI: 1.22-1.57), and three or more conditions (1.81; 95% CI: 1.61-2.04)], receipt of myelosuppressive chemotherapy (1.11; 95% CI: 0.94-1.32), and receipt of chemotherapy within 1 month of diagnosis [1 to 3 months (0.70; 95% CI: 0.62-0.80) and greater than 3 months (0.63; 95% CI: 0.55-0.73)].Conclusion: We created a prediction model for febrile neutropenia with first cycle of chemotherapy in a large population of elderly patients with common malignancies.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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