Prevalence and risks of intravenous chemotherapy-induced severe neutropenia in solid cancers: a multicenter retrospective cohort study on real-life data.
Humans
Retrospective Studies
Middle Aged
Female
Male
Aged
Neoplasms
/ drug therapy
Prevalence
Neutropenia
/ chemically induced
Antineoplastic Agents
/ adverse effects
Cohort Studies
Prognosis
Intensive Care Units
/ statistics & numerical data
Risk Factors
Severity of Illness Index
Administration, Intravenous
COVID
Delivery of health care
Health services research
Incidence
Neoplasms
Quality of health care
Routinely collected health data
Journal
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
ISSN: 1433-7339
Titre abrégé: Support Care Cancer
Pays: Germany
ID NLM: 9302957
Informations de publication
Date de publication:
13 Sep 2024
13 Sep 2024
Historique:
received:
25
01
2024
accepted:
15
08
2024
medline:
13
9
2024
pubmed:
13
9
2024
entrez:
13
9
2024
Statut:
epublish
Résumé
We aimed at identifying prevalence, clinical outcomes and prognostic factors in cancer patients with intravenous chemotherapy-induced severe neutropenia (ICISN). In this multicenter retrospective cohort study on the clinical data warehouse of Greater Paris University Hospitals (AP-HP), we included all adult patients with solid cancer hospitalized between 2016 and 2021 with intravenous chemotherapy within 30 days prior to severe neutropenia (D70 or D611 ICD-10 codes AND a neutrophil count < 500/mm3). The primary endpoint was referral to intensive care unit (ICU) or death within 30 days. We collected cancer, patient, and treatment characteristics. Among 141,586 cancer inpatients, 40,660 received chemotherapy among whom 661 (1.6%) had ICISN. Median age was 63 years (interquartile range (IQR), 54-70) and 330 patients (49%) were female. The median Charlson score was 10 (IQR, 8-11). Main primary cancers were lung (n = 204, 31%) and breast (n = 87, 13%). Advanced cancers were found in 551 patients (83%), 331 (50%) were in 1st line of chemotherapy, 284 (42%) in the 1st cycle of the current line and 149 (22%) had primary G-CSF. Documented bacterial (mostly gram-negative bacilli) and fungal infections were observed in 113 (17%) and 19 (3%) patients; 58 (9%) were transferred to ICU and 82 (12%) died within 30 days, 372 (56%) patients received subsequent chemotherapy. Independent prognostic factors were the level of monocyte, lymphocyte counts or albuminemia and a documented bacterial infection, while Charlson index and primary prophylactic G-CSF were not associated with patient clinical outcomes. Despite the use of primary G-CSF, ICISN remains a frequent event, which leads to ICU death in one on five cases Some prognostic factors of severity have been highlighted and could help clinicians to prevent severe complications.
Identifiants
pubmed: 39269541
doi: 10.1007/s00520-024-08817-4
pii: 10.1007/s00520-024-08817-4
doi:
Substances chimiques
Antineoplastic Agents
0
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
657Investigateurs
Guillaume Lamé
(G)
Christel Daniel
(C)
Ariel Cohen
(A)
Marie Verdoux
(M)
Gilles Galula
(G)
Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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