Lyman et al identified risk factors for febrile neutropenia in a patient treated for aggressive non-Hodgkin's malignant lymphoma (NHL). These can help identify a patient who may benefit from closer monitoring and more aggressive management. The authors are from the University of Washington in Seattle and Duke University in Durham.
Therapy protocols used: CNOP, CHOP or CHOP with rituximab
Parameters from multivariate analysis:
(1) age
(2) gender
(3) tumor stage
(4) ECOG performance scale
(5) body surface area (BSA)
(6) pretreatment absolute neutrophil count (ANC)
(7) administration of prophylactic colony stimulating factor (CSF)
|
Parameter |
Finding |
Points |
|
age of the patient |
<= 60 years |
0 |
|
|
> 60 years |
1 |
|
gender of the patient |
male |
0 |
|
|
female |
1 |
|
tumor stage |
I or II |
0 |
|
|
III or IV |
1 |
|
ECOG performance scale |
0 or 1 |
0 |
|
|
2, 3 or 4 |
1 |
|
body surface area |
> 2 square meters |
0 |
|
|
<= 2 square meters |
1 |
|
pretreatment ANC |
>= 1,000 per µL |
0 |
|
|
< 1,000 per µL |
1 |
|
prophylactic CSF |
given |
0 |
|
|
not given |
1 |
where:
• The adjusted odds ratios for age, gender, stage, performance and ANC range from 1.30 to 1.88.
• The adjusted odds ratio for BSA > 2 square meters was 0.85. The adjusted odds ratio for prophylactic CSF was 0.84.
number of risk factors for febrile neutropenia =
= SUM(points for all 7 risk factors)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 7
• The greater the number of risk factors the greater the risk of febrile neutropenia.
Specialty: Hematology Oncology, Infectious Diseases
ICD-10: ,
