Development of a simplified multivariable model to predict neutropenic complications in cancer patients undergoing chemotherapy
Purpose Neutropenic complications remain the major dose-limiting toxicities of cancer chemotherapy. The aim of this study was to develop and internally validate a comprehensive and easily measurable scoring system for prediction of severe or febrile neutropenia in the first chemotherapy cycle of pat...
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| Veröffentlicht in: | Supportive care in cancer 2018-11, Vol.26 (11), p.3691-3699 |
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| creator | Razzaghdoust, Abolfazl Mofid, Bahram Moghadam, Maryam |
| description | Purpose
Neutropenic complications remain the major dose-limiting toxicities of cancer chemotherapy. The aim of this study was to develop and internally validate a comprehensive and easily measurable scoring system for prediction of severe or febrile neutropenia in the first chemotherapy cycle of patients with solid tumors or lymphoma.
Methods
This prospective cohort study included consecutive patients at a tertiary referral hospital. Many clinical and laboratory-independent variables were measured at baseline. A multivariable logistic regression analysis was applied after unadjusted analysis, and the multivariable model was transformed into a simplified risk score based on 6 bootstrapped regression coefficients. The simplified scoring system was internally validated using cross-validation. All statistical tests were two-sided.
Results
A total of 305 patients were enrolled and followed during 1732 chemotherapy cycles. Of these, 259 were eligible for analysis. The multivariable model revealed 6 predictive factors for severe or febrile neutropenia (scores in parentheses): high-risk regimen without colony-stimulating factor (4 points), intermediate-risk regimen without colony-stimulating factor (3 points), age > 65 years and elevated ferritin (3 points), body mass index |
| doi_str_mv | 10.1007/s00520-018-4224-z |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2036204752</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A555987296</galeid><sourcerecordid>A555987296</sourcerecordid><originalsourceid>FETCH-LOGICAL-c439t-4a13964ca5ab4879ae0b8b7343af6d0d9cd0d7ec2e49d1e7cae124cb43cb94093</originalsourceid><addsrcrecordid>eNp1kU1rFTEUhoMo9lr9AW4k4KabqfmayWRZ2voBhW7qOmSSM7cpM8mYZArtxr9urre1KJZAAifP-3LOeRF6T8kxJUR-yoS0jDSE9o1gTDT3L9CGCs4bybl6iTZECdoI3rYH6E3ON4RQKVv2Gh0wJXnXd3KDfp7BLUxxmSEUHEdscPbzMvnRg8PzOhV_a5I3wwR4jg4mXCJeEjhvCw6wlhQXCN5iG3cqa4qPIWMfsDXBQsJLrVTrjNfgIG2jD1tsr2GO5RqSWe7eolejmTK8e3gP0ffP51enX5uLyy_fTk8uGiu4Ko0wlKtOWNOaQfRSGSBDP0guuBk7R5yy9ZJgGQjlKEhrgDJhB8HtoARR_BAd7X2XFH-skIuefbYwTSZAXLNmhHeMiLqein78B72Jawq1u98UFVRy-URtzQTahzGWZOzOVJ-0bat6yVRXqeP_UPU4mL2NAUZf638J6F5gU8w5waiX5GeT7jQlehe63oeua-h6F7q-r5oPDw2vwwzuj-Ix5QqwPZDrV9hCeproeddfNUa5jw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2036141737</pqid></control><display><type>article</type><title>Development of a simplified multivariable model to predict neutropenic complications in cancer patients undergoing chemotherapy</title><source>SpringerLink Journals</source><creator>Razzaghdoust, Abolfazl ; Mofid, Bahram ; Moghadam, Maryam</creator><creatorcontrib>Razzaghdoust, Abolfazl ; Mofid, Bahram ; Moghadam, Maryam</creatorcontrib><description>Purpose
Neutropenic complications remain the major dose-limiting toxicities of cancer chemotherapy. The aim of this study was to develop and internally validate a comprehensive and easily measurable scoring system for prediction of severe or febrile neutropenia in the first chemotherapy cycle of patients with solid tumors or lymphoma.
Methods
This prospective cohort study included consecutive patients at a tertiary referral hospital. Many clinical and laboratory-independent variables were measured at baseline. A multivariable logistic regression analysis was applied after unadjusted analysis, and the multivariable model was transformed into a simplified risk score based on 6 bootstrapped regression coefficients. The simplified scoring system was internally validated using cross-validation. All statistical tests were two-sided.
Results
A total of 305 patients were enrolled and followed during 1732 chemotherapy cycles. Of these, 259 were eligible for analysis. The multivariable model revealed 6 predictive factors for severe or febrile neutropenia (scores in parentheses): high-risk regimen without colony-stimulating factor (4 points), intermediate-risk regimen without colony-stimulating factor (3 points), age > 65 years and elevated ferritin (3 points), body mass index < 23 kg/m
2
and body surface area < 2 m
2
(2 points), estimated glomerular filtration rate < 60 mL/min/1.73m
2
(2 points), and elevated C-reactive protein (1 point). The receiver operating characteristic curve was 0.832 (95% confidence interval [Cl], 0.767–0.897) for the simplified model and 0.816 (95% Cl, 0.771–0.860) for the cross-validation.
Conclusions
We developed and internally validated a user-friendly prediction model to guide personalized decision-making using available clinical data and few cost-effective laboratory tests. External validation in other centers with different patients is required.</description><identifier>ISSN: 0941-4355</identifier><identifier>EISSN: 1433-7339</identifier><identifier>DOI: 10.1007/s00520-018-4224-z</identifier><identifier>PMID: 29736867</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Analysis ; Cancer patients ; Cancer research ; Chemotherapy ; Laboratories ; Lymphomas ; Medical schools ; Medicine ; Medicine & Public Health ; Neutropenia ; Nursing ; Nursing Research ; Oncology ; Original Article ; Pain Medicine ; Rehabilitation Medicine</subject><ispartof>Supportive care in cancer, 2018-11, Vol.26 (11), p.3691-3699</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2018</rights><rights>COPYRIGHT 2018 Springer</rights><rights>Supportive Care in Cancer is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c439t-4a13964ca5ab4879ae0b8b7343af6d0d9cd0d7ec2e49d1e7cae124cb43cb94093</citedby><cites>FETCH-LOGICAL-c439t-4a13964ca5ab4879ae0b8b7343af6d0d9cd0d7ec2e49d1e7cae124cb43cb94093</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00520-018-4224-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00520-018-4224-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,777,781,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29736867$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Razzaghdoust, Abolfazl</creatorcontrib><creatorcontrib>Mofid, Bahram</creatorcontrib><creatorcontrib>Moghadam, Maryam</creatorcontrib><title>Development of a simplified multivariable model to predict neutropenic complications in cancer patients undergoing chemotherapy</title><title>Supportive care in cancer</title><addtitle>Support Care Cancer</addtitle><addtitle>Support Care Cancer</addtitle><description>Purpose
Neutropenic complications remain the major dose-limiting toxicities of cancer chemotherapy. The aim of this study was to develop and internally validate a comprehensive and easily measurable scoring system for prediction of severe or febrile neutropenia in the first chemotherapy cycle of patients with solid tumors or lymphoma.
Methods
This prospective cohort study included consecutive patients at a tertiary referral hospital. Many clinical and laboratory-independent variables were measured at baseline. A multivariable logistic regression analysis was applied after unadjusted analysis, and the multivariable model was transformed into a simplified risk score based on 6 bootstrapped regression coefficients. The simplified scoring system was internally validated using cross-validation. All statistical tests were two-sided.
Results
A total of 305 patients were enrolled and followed during 1732 chemotherapy cycles. Of these, 259 were eligible for analysis. The multivariable model revealed 6 predictive factors for severe or febrile neutropenia (scores in parentheses): high-risk regimen without colony-stimulating factor (4 points), intermediate-risk regimen without colony-stimulating factor (3 points), age > 65 years and elevated ferritin (3 points), body mass index < 23 kg/m
2
and body surface area < 2 m
2
(2 points), estimated glomerular filtration rate < 60 mL/min/1.73m
2
(2 points), and elevated C-reactive protein (1 point). The receiver operating characteristic curve was 0.832 (95% confidence interval [Cl], 0.767–0.897) for the simplified model and 0.816 (95% Cl, 0.771–0.860) for the cross-validation.
Conclusions
We developed and internally validated a user-friendly prediction model to guide personalized decision-making using available clinical data and few cost-effective laboratory tests. External validation in other centers with different patients is required.</description><subject>Analysis</subject><subject>Cancer patients</subject><subject>Cancer research</subject><subject>Chemotherapy</subject><subject>Laboratories</subject><subject>Lymphomas</subject><subject>Medical schools</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neutropenia</subject><subject>Nursing</subject><subject>Nursing Research</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Pain Medicine</subject><subject>Rehabilitation Medicine</subject><issn>0941-4355</issn><issn>1433-7339</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp1kU1rFTEUhoMo9lr9AW4k4KabqfmayWRZ2voBhW7qOmSSM7cpM8mYZArtxr9urre1KJZAAifP-3LOeRF6T8kxJUR-yoS0jDSE9o1gTDT3L9CGCs4bybl6iTZECdoI3rYH6E3ON4RQKVv2Gh0wJXnXd3KDfp7BLUxxmSEUHEdscPbzMvnRg8PzOhV_a5I3wwR4jg4mXCJeEjhvCw6wlhQXCN5iG3cqa4qPIWMfsDXBQsJLrVTrjNfgIG2jD1tsr2GO5RqSWe7eolejmTK8e3gP0ffP51enX5uLyy_fTk8uGiu4Ko0wlKtOWNOaQfRSGSBDP0guuBk7R5yy9ZJgGQjlKEhrgDJhB8HtoARR_BAd7X2XFH-skIuefbYwTSZAXLNmhHeMiLqein78B72Jawq1u98UFVRy-URtzQTahzGWZOzOVJ-0bat6yVRXqeP_UPU4mL2NAUZf638J6F5gU8w5waiX5GeT7jQlehe63oeua-h6F7q-r5oPDw2vwwzuj-Ix5QqwPZDrV9hCeproeddfNUa5jw</recordid><startdate>20181101</startdate><enddate>20181101</enddate><creator>Razzaghdoust, Abolfazl</creator><creator>Mofid, Bahram</creator><creator>Moghadam, Maryam</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88J</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HEHIP</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2R</scope><scope>M2S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20181101</creationdate><title>Development of a simplified multivariable model to predict neutropenic complications in cancer patients undergoing chemotherapy</title><author>Razzaghdoust, Abolfazl ; Mofid, Bahram ; Moghadam, Maryam</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c439t-4a13964ca5ab4879ae0b8b7343af6d0d9cd0d7ec2e49d1e7cae124cb43cb94093</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Analysis</topic><topic>Cancer patients</topic><topic>Cancer research</topic><topic>Chemotherapy</topic><topic>Laboratories</topic><topic>Lymphomas</topic><topic>Medical schools</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neutropenia</topic><topic>Nursing</topic><topic>Nursing Research</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Pain Medicine</topic><topic>Rehabilitation Medicine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Razzaghdoust, Abolfazl</creatorcontrib><creatorcontrib>Mofid, Bahram</creatorcontrib><creatorcontrib>Moghadam, Maryam</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Social Science Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Sociology Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Social Science Database</collection><collection>Sociology Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Supportive care in cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Razzaghdoust, Abolfazl</au><au>Mofid, Bahram</au><au>Moghadam, Maryam</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Development of a simplified multivariable model to predict neutropenic complications in cancer patients undergoing chemotherapy</atitle><jtitle>Supportive care in cancer</jtitle><stitle>Support Care Cancer</stitle><addtitle>Support Care Cancer</addtitle><date>2018-11-01</date><risdate>2018</risdate><volume>26</volume><issue>11</issue><spage>3691</spage><epage>3699</epage><pages>3691-3699</pages><issn>0941-4355</issn><eissn>1433-7339</eissn><abstract>Purpose
Neutropenic complications remain the major dose-limiting toxicities of cancer chemotherapy. The aim of this study was to develop and internally validate a comprehensive and easily measurable scoring system for prediction of severe or febrile neutropenia in the first chemotherapy cycle of patients with solid tumors or lymphoma.
Methods
This prospective cohort study included consecutive patients at a tertiary referral hospital. Many clinical and laboratory-independent variables were measured at baseline. A multivariable logistic regression analysis was applied after unadjusted analysis, and the multivariable model was transformed into a simplified risk score based on 6 bootstrapped regression coefficients. The simplified scoring system was internally validated using cross-validation. All statistical tests were two-sided.
Results
A total of 305 patients were enrolled and followed during 1732 chemotherapy cycles. Of these, 259 were eligible for analysis. The multivariable model revealed 6 predictive factors for severe or febrile neutropenia (scores in parentheses): high-risk regimen without colony-stimulating factor (4 points), intermediate-risk regimen without colony-stimulating factor (3 points), age > 65 years and elevated ferritin (3 points), body mass index < 23 kg/m
2
and body surface area < 2 m
2
(2 points), estimated glomerular filtration rate < 60 mL/min/1.73m
2
(2 points), and elevated C-reactive protein (1 point). The receiver operating characteristic curve was 0.832 (95% confidence interval [Cl], 0.767–0.897) for the simplified model and 0.816 (95% Cl, 0.771–0.860) for the cross-validation.
Conclusions
We developed and internally validated a user-friendly prediction model to guide personalized decision-making using available clinical data and few cost-effective laboratory tests. External validation in other centers with different patients is required.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>29736867</pmid><doi>10.1007/s00520-018-4224-z</doi><tpages>9</tpages></addata></record> |
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| source | SpringerLink Journals |
| subjects | Analysis Cancer patients Cancer research Chemotherapy Laboratories Lymphomas Medical schools Medicine Medicine & Public Health Neutropenia Nursing Nursing Research Oncology Original Article Pain Medicine Rehabilitation Medicine |
| title | Development of a simplified multivariable model to predict neutropenic complications in cancer patients undergoing chemotherapy |
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