Vincent et al developed a tool for predicting anemia induced by palliative chemotherapy given to a patient with advanced nonsmall cell lung cancer. This can help identify a patient who may benefit from closer monitoring or preventive therapies. The authors are from the multiple institutions in Canada and Europe as well as Ortho Biotech. Inc.
NOTE: Most these authors were involved in writing the prediction model used in the previous section.
Patient selection: advanced nonsmall lung cancer receiving palliative chemotherapy
Endpoint: anemia with hemoglobin <= 100 g/L (10 g/dL)
Parameters:
(1) hemoglobin prior to chemotherapy
(2) age in years
(3) body surface area (BSA)
(4) ECOG performance status
(5) current therapy for persistent or recurrent cancer
(6) about to receive platinum-based chemotherapy
(7) about to receive gemcitabine
Parameter |
Finding |
Points |
---|---|---|
hemoglobin prior to chemotherapy |
|
-0.07 * (Hgb) |
age in years |
< 68 years of age |
0 |
|
>= 68 years of age |
0.5 |
body surface area |
>= 1.97 |
0 |
|
< 1.97 |
2 |
ECOG performance scale |
0 |
0 |
|
1 |
0.5 |
|
2 to 4 |
1 |
current therapy for persistent or recurrent cancer |
no |
0 |
|
yes |
0.5 |
about to receive platinum-based chemotherapy |
no |
0 |
|
yes |
1 |
about to receive gemcitabine |
no |
0 |
|
yes |
0.5 |
total score =
= SUM(points for all 7 parameters) + 13
Interpretation:
• minimum total score: 0 (to achieve this would require a hemoglobin of 18.6)
• maximum total score: 15
• The higher the score the greater the risk for developing anemia.
• A risk score between 8.0 and 9.99 was associated with the highest Youden index, with approximately 26% developing anemia.
• A risk score < 6 was associated with a very low risk of anemia.
Performance:
• A cutoff of 8.0 - 9.9 had a sensitivity of 83% with specificity of 68%.
• A cutoff of >=10 had a sensitivity of 32% with specificity of 90%.
Purpose: To identify a patient with advanced nonsmall lung cancer who is at risk for chemotherapy-induced anemia using the tool of Vincent et al.
Specialty: Hematology Oncology, Pharmacology, clinical
Objective: risk factors, adverse effects
ICD-10: C34, Z51, R71,