Predicting individual risk of neutropenic complications in patients receiving cancer chemotherapy.
Predicting individual risk of neutropenic complications in patients receiving cancer chemotherapy.
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DOI：
10.1002/cncr.25691
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发表时间：
2011-05-01
期刊：
影响因子：
6.2
通讯作者：
Dale, David C.
中科院分区：
文献类型：
--
作者：
Lyman, Gary H.;Kuderer, Nicole M.;Crawford, Jeffrey;Wolff, Debra A.;Culakova, Eva;Poniewierski, Marek S.;Dale, David C.
开展了一项前瞻性队列研究，以开发和验证接受化疗的癌症患者中性粒细胞减少并发症的风险模型。研究人群包括3760名患有普通实体瘤或恶性淋巴瘤的患者，他们在全美115个实习地点开始新的化疗方案。建立了中性粒细胞减少并发症的回归模型，并通过随机分裂样本选择过程进行了验证。在派生和验证总体上没有观察到显著的差异。在单变量分析中，中性粒细胞减少并发症的风险在周期1中最大，在两个队列之间的预测风险没有显着差异。经多因素分析，调整肿瘤类型和年龄后，主要独立危险因素有：既往化疗、肝肾功能异常、低白细胞、化疗和计划分娩≥为85%。在预测风险临界点为10%时，模型测试的表现包括：敏感性90%，特异性59%，预测值阳性和阴性分别为34%和96%。进一步的分析证实了多个化疗周期中性粒细胞减少症风险的模型判别。建立了中性粒细胞减少并发症的风险模型，并在一大批开始癌症化疗的患者中进行了验证，该模型可能会指导有效和经济高效地使用可用的支持性治疗。
A prospective cohort study was undertaken to develop and validate a risk model for neutropenic complications in cancer patients receiving chemotherapy. The study population consisted of 3760 patients with common solid tumors or malignant lymphoma who were beginning a new chemotherapy regimen at 115 practice sites throughout the United States. A regression model for neutropenic complications was developed and then validated by using a random split-sample selection process. No significant differences in the derivation and validation populations were observed. The risk of neutropenic complications was greatest in cycle 1 with no significant difference in predicted risk between the 2 cohorts in univariate analysis. After adjustment for cancer type and age, major independent risk factors in multivariate analysis included: prior chemotherapy, abnormal hepatic and renal function, low white blood count, chemotherapy and planned delivery ≥85%. At a predicted risk cutpoint of 10%, model test performance included: sensitivity 90%, specificity 59%, and predictive value positive and negative of 34% and 96%, respectively. Further analysis confirmed model discrimination for risk of febrile neutropenia over multiple chemotherapy cycles. A risk model for neutropenic complications was developed and validated in a large prospective cohort of patients who were beginning cancer chemotherapy that may guide the effective and cost-effective use of available supportive care.
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DOI：
10.1097/00001648-199001000-00010
发表时间：
1990-01-01
期刊：
Epidemiology (Cambridge, Mass.)
影响因子：
--
作者：
Rothman, K J
通讯作者：
Rothman, K J
影响因子：
5.8
作者：
Molinaro, AM;Simon, R;Pfeiffer, RM
通讯作者：
Pfeiffer, RM
DOI：
10.6004/jnccn.2009.0009
发表时间：
2009-01-01
影响因子：
13.4
作者：
Lyman, Gary H.
通讯作者：
Lyman, Gary H.
影响因子：
6.2
作者：
Shayne, Michelle;Culakova, Eva;Lyman, Gary H.
通讯作者：
Lyman, Gary H.
影响因子：
5.8
作者：
Lyman, GH;Lyman, CH;Agboola, O
通讯作者：
Agboola, O