Document 1079
 DOCN  M9471079
 TI    Early lymphopenia is a risk factor for chemotherapy induced febrile
       neutropenia: description of a prognostic index (Meeting abstract).
 DT    9409
 AU    Blay J-Y; Anglaret B; Lasset C; Freyer G; Chauvin F; Biron P; Center L.
       Berard (CLB), 28 rue Laennec, 69008 Lyon, France
 SO    Proc Annu Meet Am Soc Clin Oncol; 13:A1506 1994. Unique Identifier :
       AIDSLINE ICDB/94601499
 AB    Febrile neutropenia (FN) is a frequent life threatening complication of
       cytotoxic chemotherapy (CT) whose incidence depends on the doses and
       drugs and individual factors. Here, we have investigated risk factors
       (RF) for FN in a retrospective series of 112 cancer patients (pts)
       treated at the CLB in 1992. Pts were over 18 years, HIV negative, not
       treated concomitantly with cytokines, and received conventional (ie,
       without stem cell support) CT. Univariate analysis showed that high risk
       CT (ie, including 2 or more of these criteria per course: ADM greater
       than 50 mg/m2, CDDP greater than 100 mg/m2, CPM greater than 1 g/m2,
       ifosfamide greater than 5 g/m2, VP16 greater than 350 mg/m2, ARA-C
       greater than 1 g/m2) and d5 lymphocyte (Ly) counts less than 700/uL, but
       not d1 or d5 PMN counts nor d1 Ly counts, correlated to the risk of FN.
       A multivariate logistic regression was performed to identify independent
       RF for FN among the following parameters: age greater than 60, PS, high
       risk CT, metastases (yes vs no), bone marrow involvement, number of
       previous courses of CT, number of relapses, d1 and d5 PMN counts (less
       than vs greater than 1500/uL), d1 and d5 Ly counts (less than vs greater
       than 700/uL). Only high risk CT and d5 Ly were independent RF (beta:
       -1.99+/-0.57 and -2.06+/-0.56 respectively). The observed incidence of
       FN in patients with none, one and two of these 2 RF was 1/44 (2%), 12/42
       (28%) and 17/26 (65%). This model was then tested on a distinct
       prospective series of 116 pts treated between April and June 1993 in the
       CLB. The observed incidence of pts with none, one and 2 of these 2 RF
       was respectively 2/56 (3%), 11/50 (22%) and 13/20 (65%) respectively,
       confirming the value of the model. These results indicate that early
       lymphopenia after cytotoxic chemotherapy is a risk factor for FN and
       describe a predictive model for FN with potential clinical value.
 DE    Antineoplastic Agents/*ADVERSE EFFECTS  Cisplatin/ADVERSE EFFECTS
       Cyclophosphamide/ADVERSE EFFECTS  Cytarabine/ADVERSE EFFECTS
       Doxorubicin/ADVERSE EFFECTS  Etoposide/ADVERSE EFFECTS  Fever/*ETIOLOGY
       Human  Ifosfamide/ADVERSE EFFECTS  Lymphopenia/CHEMICALLY
       INDUCED/*PHYSIOPATHOLOGY  Neutropenia/*CHEMICALLY INDUCED  Prognosis
       Retrospective Studies  Risk Factors  MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).