Thrombocytosis Increases the Risk of Chemotherapy-Associated Thrombosis.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 282-282
Author(s):  
Alok A. Khorana ◽  
Charles W. Francis ◽  
Eva Culakova ◽  
Gary H. Lyman
Keyword(s):  
Platelet Count ◽  
Cancer Patients ◽  
Performance Status ◽  
Univariate Analysis ◽  
Ecog Performance Status ◽  
Clinical Variables ◽  
Platelet Counts ◽  
The Mean ◽  
Independent Association ◽  
Chemotherapy Patients

Abstract Background: Venous thromboembolism (VTE) is a frequent and significant complication of cancer and of chemotherapy, with an estimated risk of 0.04%/month (0.5%/year). Patients with thrombocytopenia are widely perceived to be at low-risk for VTE. Conversely, thrombocytosis may contribute to risk of VTE, but this has not been well-studied. We conducted a prospective analysis to determine the association of platelet counts with the incidence of symptomatic VTE in cancer patients receiving chemotherapy. Methods: The Awareness of Neutropenia in Cancer (ANC) Study Group is currently enrolling patients with breast, lung, colon, ovary and other cancers, at 137 sites nationwide, with an accrual goal of 4,500 patients. Patients are registered at the time of initiation of a new chemotherapy regimen, and followed for 4 cycles. The association of VTE with platelet counts and other clinical variables was studied in univariate analysis and in a multiple logistic regression model. Results: A total of 2,151 patients treated with at least one cycle of chemotherapy were available for analysis. Of these, 18.1% had platelet counts <200,000 and 21.5% had counts ≥350,000 prior to initiating chemotherapy. Symptomatic VTE occurred in 46 patients, for an incidence of 2.14% over a median follow-up of 2.5 months (0.85%/month). The incidence of VTE by quartiles of pre-chemotherapy platelet counts is shown in the figure. VTE occurred in 4.34% (1.73%/month) of patients with platelet counts of ≥ 350,000 prior to initiation of chemotherapy. This was significantly greater than 1.8% (0.72%/month) incidence in those with baseline counts of <200,000 (p=0.035). Similarly, the mean platelet count prior to chemotherapy was higher for patients who developed VTE than for those who did not (351,000 versus 288,000, p=0.007). Platelet counts during chemotherapy were also associated with risk for VTE. The mean platelet count at nadir during the cycle VTE occurred was 202,000. This was significantly greater than the mean nadir count of 157,000 for corresponding cycles in patients who did not develop VTE (p=0.007). Other clinical variables associated with development of VTE included primary site of cancer, ECOG performance status ≥ 2, and baseline use of erythropoietin or colony-stimulating factors. A baseline platelet count of ≥ 350,000 continued to be significantly associated with VTE after adjusting for other risk factors in a multivariate analysis (odds ratio 3.00, 95% CI 1.61–5.55, p=0.0005). Conclusion: This is the first report describing an independent association of platelet counts with symptomatic VTE in cancer patients receiving chemotherapy. Patients with platelet counts of ≥ 350,000 prior to initiation of chemotherapy are at a three-fold greater risk for developing VTE. The role of platelets in the pathogenesis of chemotherapy-associated thrombosis warrants further study. Platelet counts should be taken into account when defining high-risk patients for thromboprophylaxis. Figure Figure

Thromboembolic events in breast cancer patients: A large series.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9589-9589 ◽  
Author(s):  
Danilo Souza Reboucas ◽  
Luiz Claudio Santos Thuler ◽  
Maria Eduarda Ferro Costa ◽  
Alvaro Henrique Ingles Garces ◽  
Luciana Carla Martins de Aquino ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Cox Regression ◽  
Performance Status ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression Model ◽  
Control Group ◽  
Thromboembolic Events ◽  
Breast Cancer Patients ◽  
Ecog Performance Status

9589 Background: Breast cancer is frequently associated with thromboembolic events (TEE). TEE may result in significant morbidity, a substantial economic burden and they represent a leading cause of death. Methods: We conducted a case-control study to analyze patients’ baseline and treatment characteristics in predicting TEE occurrence as well as the prognosis of breast cancer patients with thromboembolic events. We identified all breast cancer patients with a TEE at INCA (Brazilian National Cancer Institute), between January 2007 and December 2011. The control group consisted of breast cancer patients that had a doppler ultrasound with normal findings during the same period. Variables found to be significant (P <0.10) by univariate analysis were subsequently entered into a multivariate logistic regression model. We used Kaplan-Meier and Cox regression for survival analysis. Results: Overall, 225 patients that developed TEE were compared to 225 matched controls. The majority of events were deep vein thrombosis of the lower extremity (78.7%) and unilateral (94.2%). Most TEE occurred within the first 3 years after the diagnosis of cancer (66.2%), with the highest incidence observed in the initial 6 months. Factors associated with the development of TEE were: age above 50 years (OR 1.85, 95% CI: 1.16 to 2.95), ECOG performance status (PS) equal to or above 3 (OR 2.01, CI 95%: 1.24 to 3.26) and the presence of a central venous catheter (CVC) (OR 2.56, 95% CI: 1.42 to 4.62). The occurrence of TEE led to systemic treatment changes (44.9%) and, most importantly, it was associated with decreased survival (HR = 1.34, 95% CI: 1.01 to 1.77, p = 0.041). Conclusions: This large retrospective analysis of TEE in breast cancer patients confirms that most events occur early in the treatment course. The incidence of TEE was associated with patients’ age, PS, and the presence of CVC. Prospective studies are needed to evaluate outpatient thromboprophylaxis for selected groups of patients.

Outcomes of Referrals for Mild and Moderate Thrombocytopenia

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 41-41
Author(s):  
Charles Schlappi ◽  
David McCall ◽  
Prasannalaxmi Palabindela ◽  
Christy Bemrich Stolz ◽  
Lee Hilliard ◽  
...  
Keyword(s):  
Platelet Count ◽  
Chart Review ◽  
Univariate Analysis ◽  
Retrospective Chart Review ◽  
Severe Thrombocytopenia ◽  
Platelet Counts ◽  
Pediatric Hematology ◽  
Normal Platelet Count ◽  
Normal Platelet ◽  
The Mean

Abstract Thrombocytopenia is a common reason for referral to a Pediatric Hematologist Oncologist. However, the need for acute intervention in patients with mild or moderate thrombocytopenia is likely a rare event. Because mild and moderate thrombocytopenia is less likely to need intervention and could resolve, the potentially stressful impact of referral to an Oncology center needs consideration. But with minimal literature to support the hypothesis that mild to moderate thrombocytopenia is unlikely associated with severe or progressive hematologic diseases, our ability to provide evidence based recommendations for need for referral is limited. To better understand the course for patients with mild and moderate thrombocytopenia, we conducted a retrospective chart review to assess the prevalence, outcomes, and need for intervention among patients referred for thrombocytopenia. Methods: We conducted a retrospective chart review of 1,140 patients referred to a large Pediatric Hematology Oncology program over a three year period (2012-2014). The diagnosis and demographics were recorded for every patient. Platelet counts at time of referral, lowest platelet count, and current platelet count were recorded and categorized as mild (plt: 100-149x103/mL), moderate (plt: 50-99 x103/mL), severe (plt: 20-49 x103/mL), and very severe (plt: <20 x103/mL). Therapeutic interventions and reason for intervention were recorded. Finally, ANA, platelet antibody and IgG levels were recorded. Descriptive statistics and univariate analysis were conducted using JMP10. Results: In a three year period (2012-2014), 1140 patients were referred to Pediatric Hematology Oncology, 902 of these patients for hematologic diagnoses. One hundred and three (11.4%) of 902 Hematology patients were referred for thrombocytopenia. The mean age of patients with thrombocytopenia was 9.2 years (s.d. 5.8yrs) and 58% were male. At the time of referral, 29% were categorized as mild, 33% were moderate, 17% severe and 21% very severe. The mean platelet count was 68 x103/mL (range 3-143). Younger patients had lower platelet counts (p<0.001), but no differences in mean platelet count were identified by gender (F:M 59 vs. 75 x103/mL, p=0.06). Thirty patients were categorized as mild thrombocytopenia at the time of referral. Only 2 (6%) patients needed eventual treatment (Crohn's disease and SLE treated by subspecialist) and 7 (23%) patients had at least one episode of moderate thrombocytopenia. On their most recent platelet count, 17 (57%) patients remained categorized as mild, 1 (3%) was moderate, and 12 (40%) had a normal platelet count. Thirty four patients were categorized as moderate thrombocytopenia at the time of referral. Only 5 (15%) patients needed eventual treatment (3 ITP patients for QOL/bruising/petechiae, one for SLE and one for NAIT) and 4 (12%) patients had at least one episode categorized as severe thrombocytopenia. On their most recent platelet count, 9 (26%) patients remained categorized as moderate, 10 (29%) were mild, and 15 (44%) had a normal platelet count. At time of diagnosis, 9 of 17 (53%) patients with severe thrombocytopenia and 19 of 22 (86%) of patients with very severe thrombocytopenia required interventions. Currently, 19 of the 39 (49%) patients have normal platelet counts. Other known diagnoses for the 103 patients include: rheumatologic diagnoses (n=5), drug induced (n=5), NAIT (n=3), ADP deficiency (n=1), X-linked thrombocytopenia (n=1), HSP (n=1), HIV (n=1), and Crohn's (n=1) Conclusion: Mild and moderate thrombocytopenia does not often progress or require interventions. Pediatricians should evaluate for Rheumatologic disorders in their initial work-up for mild to moderate thrombocytopenia as well as consider medication-induced thrombocytopenia. A safe and cost-effective approach to a patient with mild to moderate thrombocytopenia could be to observe repeat laboratory data (including ANA) in lieu of any other co-morbid condition. This approach could save families time, money, effort, and emotional stress in making appointments at large referral institutions. Disclosures No relevant conflicts of interest to declare.

Predictive Factors for the Development of Dyspnea Within 7 Days After Admission Among Terminally Ill Cancer Patients

2021 ◽  
pp. 104990912110288
Author(s):  
Ryo Matsunuma ◽  
Takashi Yamaguchi ◽  
Masanori Mori ◽  
Tomoo Ikari ◽  
Kozue Suzuki ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Predictive Factors ◽  
Performance Status ◽  
Univariate Analysis ◽  
Terminally Ill ◽  
Primary Lung Cancer ◽  
Poor Performance Status ◽  
Terminally Ill Cancer Patients ◽  
Development Group

Background: Predictive factors for the development of dyspnea have not been reported among terminally ill cancer patients. Objective: This current study aimed to identify the predictive factors attributed to the development of dyspnea within 7 days after admission among patients with cancer. Methods: This was a secondary analysis of a multicenter prospective observational study on the dying process among patients admitted in inpatient hospices/palliative care units. Patients were divided into 2 groups: those who developed dyspnea (development group) and those who did not (non-development group). To determine independent predictive factors, univariate and multivariate analyses using the logistic regression model were performed. Results: From January 2017 to December 2017, 1159 patients were included in this analysis. Univariate analysis showed that male participants, those with primary lung cancer, ascites, and Karnofsky Performance Status score (KPS) of ≤40, smokers, and benzodiazepine users were significantly higher in the development group. Multivariate analysis revealed that primary lung cancer (odds ratio [OR]: 2.80, 95% confidence interval [95% CI]: 1.47-5.31; p = 0.002), KPS score (≤40) (OR: 1.84, 95% CI: 1.02-3.31; p = 0.044), and presence of ascites (OR: 2.34, 95% CI: 1.36-4.02; p = 0.002) were independent predictive factors for the development of dyspnea. Conclusions: Lung cancer, poor performance status, and ascites may be predictive factors for the development of dyspnea among terminally ill cancer patients. However, further studies should be performed to validate these findings.

Impact of ECOG performance status on recurrent/metastatic head and neck squamous cell carcinomas treated with anti-PD1 inhibitors.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18004-e18004
Author(s):  
Cameron Chalker ◽  
Vicky Wu ◽  
Jenna M. Voutsinas ◽  
Victoria Hwang ◽  
Christina S Baik ◽  
...  
Keyword(s):  
Overall Survival ◽  
Clinical Outcomes ◽  
Squamous Cell ◽  
Smoking Status ◽  
Demographic Data ◽  
Performance Status ◽  
Univariate Analysis ◽  
Single Agent ◽  
Ecog Performance Status ◽  
Hpv Status

e18004 Background: Anti-PD1 checkpoint inhibitors (ICI) represent an established standard of care for patients with recurrent/metastatic head & neck squamous cell carcinoma (RMHNSCC). Landmark studies excluded patients with ECOG performance status (PS) ≥ 2; the benefit of ICI in this population is therefore unknown. Methods: We retrospectively reviewed RMHNSCC patients who received at least 1 dose of ICI at our institution. Demographic data and clinical outcomes were obtained; the latter included objective response to ICI (ORR), physician-documented CTCAE grade 2+ toxicity (irAE), and any unplanned hospitalization within 100-days of last ICI dose (UH). Associations between demographic data and clinical outcomes were explored using both uni- and multivariate analysis. Overall survival (OS) was estimated using a Cox proportional hazards model; ORR, irAE, and UH were evaluated with logistic regression. This project was approved by our institutional IRB. Results: We identified 152 RMHNSCC patients who were treated with ICI between 1/2013 and 1/2019. ECOG PS was 0 in 42 (27%), 1 in 75 (50%), 2 in 27 (18%), 3 in 2 (1%), and unknown in 6 (4%) patients. The median age was 61 (range: 25 - 90). 124 (82%) were male, 124 (82%) were white, and 69 (45%) were never-smokers. The most common primary sites were the oropharynx (n = 59, 40%), oral cavity (n = 39, 26%), nasopharynx (n = 11, 7%), and larynx (n = 10, 6%). 54 (36%) were p16+ oropharynx cancers. CPS score was available in 10 (6.6%). Single agent ICI was received by 118 (77%) patients. 66 (44%) had a documented irAE and 54 (36%) had an UH. A multivariate model for OS containing PS, smoking status and HPV status showed a strong association between inferior OS and ECOG 2/3 compared to 0/1 (p < 0.001; HR = 3.30, CI = 2.01-5.41), as well as former (vs. never) smoking status (p < 0.001; HR = 2.17, CI = 1.41-3.35). Current smoking (p = 0.25) did not reach statistical significance. On univariate analysis, poor PS was associated with inferior ORR (p = 0.03; OR = 0.25, CI = 0.06-0.77) and increased UH (p = 0.04; OR = 2.43, CI = 1.05—5.71). There was no significant association between irAE and any patient characteristic. Conclusions: We observed inferior overall survival among ICI-treated RMHNSCC patients with ECOG 2/3 in our single-institution, retrospective series. Our findings help frame discussion of therapeutic options in this poor-risk population. Further study must be done to determine which interventions are of greatest benefit for RMHNSCC patients with declining performance status.

scholarly journals Romiplostim Treatment of Chemotherapy-Induced Thrombocytopenia

2019 ◽  
Vol 37 (31) ◽  
pp. 2892-2898 ◽  
Author(s):  
Gerald A. Soff ◽  
Yimei Miao ◽  
Gemma Bendheim ◽  
Jeanette Batista ◽  
Jodi V. Mones ◽  
...  
Keyword(s):  
Platelet Count ◽  
Cancer Treatment ◽  
Usual Care ◽  
Randomized Trial ◽  
Dose Reduction ◽  
Solid Tumors ◽  
Prospective Trial ◽  
End Point ◽  
The Mean ◽  
Chemotherapy Patients

PURPOSE Chemotherapy-induced thrombocytopenia (CIT) leads to delay or reduction in cancer treatment. There is no approved treatment. METHODS We conducted a phase II randomized trial of romiplostim versus untreated observation in patients with solid tumors with CIT. Before enrollment, patients had platelets less than 100,000/μL for at least 4 weeks, despite delay or dose reduction of chemotherapy. Patients received weekly titrated romiplostim with a target platelet count of 100,000/μL or more, or were monitored with usual care. The primary end point was correction of platelet count within 3 weeks. Twenty-three patients were treated in a randomization phase, and an additional 37 patients were treated in a single-arm, romiplostim phase. Resumption of chemotherapy without recurrent CIT was a secondary end point. RESULTS The mean platelet count at enrollment was 62,000/μL. In the randomization phase, 14 of 15 romiplostim-treated patients (93%) experienced correction of their platelet count within 3 weeks, compared with one of eight control patients (12.5%; P < .001). Including all romiplostim-treated patients (N = 52), the mean platelet count at 2 weeks of treatment was 141,000/μL. The mean platelet count in the eight observation patients at 3 weeks was 57,000/μL. Forty-four patients who achieved platelet correction with romiplostim resumed chemotherapy with weekly romiplostim. Only three patients (6.8%) experienced recurrent reduction or delay of chemotherapy because of isolated CIT. CONCLUSION This prospective trial evaluated treatment of CIT with romiplostim. Romiplostim is effective in correcting CIT, and maintenance allows for resumption of chemotherapy without recurrence of CIT in most patients.

Risk Model for Severe Anemia Requiring Red Blood Cell Transfusion After Cytotoxic Conventional Chemotherapy Regimens

1999 ◽  
Vol 17 (9) ◽  
pp. 2840-2840 ◽  
Author(s):  
I. Ray-Coquard ◽  
A. Le Cesne ◽  
M. T. Rubio ◽  
J. Mermet ◽  
C. Maugard ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Lymphocyte Count ◽  
Risk Model ◽  
Risk Index ◽  
Performance Status ◽  
Univariate Analysis ◽  
Hemoglobin Level ◽  
Red Blood Cell Transfusion ◽  
Severe Anemia ◽  
Calculated Probability

PURPOSE: Cancer patients frequently experience anemia as a consequence of myelosuppressive therapy or bone marrow invasion. PATIENTS AND METHODS: A risk model for chemotherapy-induced severe anemia requiring RBC transfusions (SARRT) within 31 days after the administration of chemotherapy was delineated in the cohort of cancer patients treated with chemotherapy in the Department of Medicine of Centre Léon Bérard in 1996 (CLB-1996). The risk model was tested on a series of 797 patients treated in 1997 (CLB-1997) and on 295 patients included in a multicenter prospective series (ELYPSE 1). RESULTS: One hundred seven of the 1,051 patients of the CLB-1996 cohort (10%) experienced SARRT. In univariate analysis, only female sex, performance status greater than 1, hemoglobin level less than 12 g/dL before chemotherapy on day 1 (d1), and d1 lymphocyte count ≤ 700/μL significantly correlated with the risk of SARRT. Using logistic regression, d1 hemoglobin level less than 12 g/dL (odds ratio [OR] = 14.0; 95% confidence interval [CI], 7 to 30), performance status greater than 1 (OR = 2.2; 95% CI, 1.4 to 3.5), and d1 lymphocyte count ≤ 700/μL (OR = 1.7; 95% CI, 1.1 to 2.6) were identified as independent risk factors for SARRT. These three factors were given arbitrary risk coefficients of 3, 1, and 1 respectively, and a risk score for each individual patient was obtained by adding the coefficients. The calculated probability of RBC transfusions was 30% for patients with a score ≥ 4, and 11%, 4%, and 1% in patients with a score of 2 or 3, 1, and 0 respectively. This model was then tested and validated in the CLB-1997 and ELYPSE 1 series. CONCLUSION: This risk index could be useful to identify patients at high risk for chemotherapy-induced SARRT who might be appropriate candidates for prophylactic erythropoietin treatment.

Survival Prediction in Terminally Ill Cancer Patients by Clinical Estimates, Laboratory Tests, and Self-Rated Anxiety and Depression

2007 ◽  
Vol 25 (22) ◽  
pp. 3313-3320 ◽  
Author(s):  
Stephan Gripp ◽  
Sibylle Moeller ◽  
Edwin Bölke ◽  
Gerd Schmitt ◽  
Christiane Matuschek ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Cancer Patients ◽  
Emotional Distress ◽  
Laboratory Tests ◽  
Performance Status ◽  
Univariate Analysis ◽  
Depression Scale ◽  
Tumor Board ◽  
Anxiety And Depression ◽  
Survival Prediction

Purpose To study how survival of palliative cancer patients relates to subjective prediction of survival, objective prognostic factors (PFs), and individual psychological coping. Patients and Methods Survival was estimated according to three categories (< 1 month, 1 to 6 months, and > 6 months) by two physicians (A and B) and the institutional tumor board (C) for 216 patients recently referred for palliative radiotherapy. After 6 months, the accuracy of these estimates was assessed. The prognostic relevance of clinical symptoms, performance status, laboratory tests, and self-reported emotional distress (Hospital Anxiety and Depression Scale) was investigated. Results In 61%, 55%, and 63% of the patients, prognoses were correctly estimated by A, B, and C, respectively. κ statistic showed fair agreement of the estimates, which proved to be overly optimistic. Accuracy of the three estimates did not improve with increasing professional experience. In particular, the survival of 96%, 71%, and 87% of patients who died in less than 1 month was overestimated by A, B, and C, respectively. On univariate analysis, 11 of 27 parameters significantly affected survival, namely performance status, primary cancer, fatigue, dyspnea, use of strong analgesics, brain metastases, leukocytosis, lactate dehydrogenase (LDH), depression, and anxiety. On multivariate analysis, colorectal and breast cancer had a favorable prognosis, whereas brain metastases, Karnofsky performance status less than 50%, strong analgesics, dyspnea, LDH, and leukocytosis were associated with a poor prognosis. Conclusion This study revealed that physicians' survival estimates were unreliable, especially in the case of patients near death. Self-reported emotional distress and objective PFs may improve the accuracy of survival estimates.

Assessment of Hematologic and Non-Hematologic Toxicity in Older Cancer Patients Receiving Systemic Chemotherapy: Results from a Prospective Nationwide Registry.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 3131-3131
Author(s):  
Naeem Tahir ◽  
Jerome H. Goldschmidt ◽  
Eva Culakova ◽  
Marek S. Poniewierski ◽  
Debra A. Wolff ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Multivariate Analysis ◽  
Cancer Patients ◽  
Performance Status ◽  
Univariate Analysis ◽  
Hematologic Toxicity ◽  
Breast Cancer Patients ◽  
Nationwide Registry ◽  
Older Cancer Patients ◽  
Grade Iii

Abstract Introduction: Although 60% of all malignancies occur in patients ≥65, this population is poorly represented in cancer clinical trials. While fit elderly patients appear to tolerate chemotherapy as well as younger individuals, less is known about chemotherapy tolerance in older cancer patients with poor performance status or co-morbidities. The purpose of this study was to examine the impact of patient and disease characteristics on the reported toxicities of cancer chemotherapy. Methods: This study represents part of a prospective, nationwide registry based at 137 randomly selected practice sites throughout the US. The major malignancies considered were cancers of the breast (33%), colon (10%), lung (19%) and ovary (7%) along with malignant lymphoma (8%). To date, 3422 patients have been registered of which 2719 are available for analysis including 1083 patients age ≥65 (40%). Primary outcome measures were: relative dose intensity (RDI) compared to standard doses, anemia (Hgb &lt;10), neutropenia (neutrophils &lt;1000) and non-hematologic toxicities pertinent to older adults including stomatitis, diarrhea, anorexia, dehydration and weight loss. Univariate and multivariate logistic regression analysis was performed to compare the difference between the 65–74 and ≥75 age groups. Results: Complete data were available on 927 patients ≥65 years of age. Among breast cancer patients, increasing age (&lt;65, 65–74, ≥75) was associated with progressively less Grade III/IV neutropenia (62%, 51% and 41%), respectively (p=0.006). This corresponds to patients receiving progressively less RDI (93.4%, 91.3%, 89.8%; P=.025) with 17%, 19% and 25% receiving RDI &lt;85%, respectively. Most of the reduced RDI was planned in patients ≥75 years compared with less than half in younger patients (P=.035). Non-breast cancer patients experienced no significant difference in rates of Grade III/IV neutropenia by age. Increasing age was associated with progressively more anemia (27%, 34%, and 44%) respectively (p&lt;0.0001) among non-breast cancer patients but not among those with breast cancer. Despite a trend, no significant increase in non-hematologic toxicities was observed with increasing age in breast cancer or non-breast cancer patients. Factors significantly associated with Grade III/IV neutropenia in univariate analysis included baseline ANC &lt;3000, BSA&lt;2.0, female gender and anthracycline containing regimens. In multivariate analysis, after adjusting for tumor type and performance status the following were significant predictors of Grade III/IV neutropenia: BSA&lt;2.0 (OR=1.5 p=0.04), Baseline ANC&lt;3000 (OR=2.0 p=0.001) and anthracycline containing regimen (OR=3.5 p&lt;0.0001). Factors associated with non-hematologic toxicity in univariate analysis included colon cancer (p&lt;0.0001), Charlson Co-morbidity Index (CCI) ≥ 3 (p=0.068), ECOG performance status ≥2 (p=0.05), and 5-Fluorouracil containing regimens (p&lt;0.0001) while in multivariate analysis, only the CCI maintained a trend towards increased non-hematologic toxicity (p=0.069). Conclusions: While anemia increases with age in non-breast cancer patients, neutropenia decreases with increasing age in breast cancer patients, most likely as a result of age-related reductions in RDI.

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