Predicting the Risk of Neutropenic Complications in Patients Treated With Adjuvant Chemotherapy for Early-Stage Breast Cancer

2.50
Hdl Handle:
http://hdl.handle.net/10755/165597
Category:
Abstract
Type:
Presentation
Title:
Predicting the Risk of Neutropenic Complications in Patients Treated With Adjuvant Chemotherapy for Early-Stage Breast Cancer
Author(s):
Cappozzo, Carrie
Author Details:
Carrie Cappozzo, Albany Medical Center, Albany, New York, USA
Abstract:
Neutropenia is associated with increased morbidity and decreased quality of life in patients treated with chemotherapy for cancer. As the primary dose-limiting toxicity of chemotherapy, neutropenia frequently results in chemotherapy delays and dose reductions that can compromise treatment effectiveness and long-term survival. Prophylactic G-CSF reduces the incidence and severity of neutropenic complications including low relative dose intensity (RDI) and febrile neutropenia (FN). A tool to predict the risk of neutropenic complications with chemotherapy would facilitate the proactive management of neutropenia by identifying patients who most likely would benefit from prophylactic G-CSF. The first step in developing such a tool is to identify predictive risk factors associated with neutropenic complications. Accordingly, we retrospectively performed multivariate logistic regression analysis on data from the records of 20,799 patients given multiple cycles of adjuvant chemotherapy for early-stage breast cancer. Developed from a nationwide survey of 1,243 community oncology practices, this large database contains detailed information on patient demographic and clinical characteristics; planned chemotherapy dose and schedule, subsequent treatment delays, dose reductions, and RDI; and the incidence of FN. Study endpoints were low RDI and FN. Covariates that independently predicted low RDI were increasing age, positive estrogen receptors (ER), decreasing body surface area (BSA), low pretreatment blood counts (WBC or ANC), and chemotherapy regimen. The adjusted odds ratios for low RDI were 1.44 for age 65 or older, 1.59 for low pretreatment blood counts, and 2.46 and 2.07 for the CAF and CMF regimens, respectively. The covariates that independently predicted FN were increasing age, negative ER, decreasing BSA, low pretreatment blood counts, and chemotherapy regimen. The adjusted odds ratios for FN were 1.23 for age 65 or older, 1.70 for low pretreatment blood counts, and 1.87 and 1.92 for the AC-T and A-CMF regimens, respectively. This study confirms the ability to develop predictive models for neutropenic complications with adjuvant chemotherapy for breast cancer. Ultimately, the factors identified here and others may be incorporated into predictive models for determining which patients should be given prophylactic G-CSF. Such models would enable nurses to intervene early to help prevent serious complications related to neutropenia.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2002
Conference Name:
27th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
Washington, D.C., USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titlePredicting the Risk of Neutropenic Complications in Patients Treated With Adjuvant Chemotherapy for Early-Stage Breast Canceren_GB
dc.contributor.authorCappozzo, Carrieen_US
dc.author.detailsCarrie Cappozzo, Albany Medical Center, Albany, New York, USAen_US
dc.identifier.urihttp://hdl.handle.net/10755/165597-
dc.description.abstractNeutropenia is associated with increased morbidity and decreased quality of life in patients treated with chemotherapy for cancer. As the primary dose-limiting toxicity of chemotherapy, neutropenia frequently results in chemotherapy delays and dose reductions that can compromise treatment effectiveness and long-term survival. Prophylactic G-CSF reduces the incidence and severity of neutropenic complications including low relative dose intensity (RDI) and febrile neutropenia (FN). A tool to predict the risk of neutropenic complications with chemotherapy would facilitate the proactive management of neutropenia by identifying patients who most likely would benefit from prophylactic G-CSF. The first step in developing such a tool is to identify predictive risk factors associated with neutropenic complications. Accordingly, we retrospectively performed multivariate logistic regression analysis on data from the records of 20,799 patients given multiple cycles of adjuvant chemotherapy for early-stage breast cancer. Developed from a nationwide survey of 1,243 community oncology practices, this large database contains detailed information on patient demographic and clinical characteristics; planned chemotherapy dose and schedule, subsequent treatment delays, dose reductions, and RDI; and the incidence of FN. Study endpoints were low RDI and FN. Covariates that independently predicted low RDI were increasing age, positive estrogen receptors (ER), decreasing body surface area (BSA), low pretreatment blood counts (WBC or ANC), and chemotherapy regimen. The adjusted odds ratios for low RDI were 1.44 for age 65 or older, 1.59 for low pretreatment blood counts, and 2.46 and 2.07 for the CAF and CMF regimens, respectively. The covariates that independently predicted FN were increasing age, negative ER, decreasing BSA, low pretreatment blood counts, and chemotherapy regimen. The adjusted odds ratios for FN were 1.23 for age 65 or older, 1.70 for low pretreatment blood counts, and 1.87 and 1.92 for the AC-T and A-CMF regimens, respectively. This study confirms the ability to develop predictive models for neutropenic complications with adjuvant chemotherapy for breast cancer. Ultimately, the factors identified here and others may be incorporated into predictive models for determining which patients should be given prophylactic G-CSF. Such models would enable nurses to intervene early to help prevent serious complications related to neutropenia.en_GB
dc.date.available2011-10-27T12:21:33Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:21:33Z-
dc.conference.date2002en_US
dc.conference.name27th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationWashington, D.C., USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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