Grade 4 Neutropenia Frequency as a Binary Risk Predictor for Adverse Clinical Consequences of Chemotherapy‑Induced Neutropenia: A Meta-analysis

Cancer Invest. 2023 Apr;41(4):369-378. doi: 10.1080/07357907.2023.2179064. Epub 2023 Mar 8.

Abstract

Neutropenia is the major toxicity of myelosuppressive cancer chemotherapy. Grade 4 neutropenia (Gr4N) is a measure of chemotherapy-induced neutropenia (CIN) severity. We conducted a meta-analysis of CIN data. Gr4N incidence was significantly correlated with febrile neutropenia (FN), days of severe neutropenia (DSN), and nadir absolute neutrophil count (ANC), which are all important predictors of morbidity. With a Gr4N threshold of 65%, both FN and DSN were below levels for low risk of adverse CIN outcomes. Gr4N was highly predictive for adverse CIN outcomes, and a 65% threshold demarcated low vs. high risk for FN and other adverse CIN outcomes.

Keywords: Growth factors & receptor; febrile neutropenia; neutropenia; outcomes research; prognosis and response predictions; supportive care & symptom control.

Publication types

  • Meta-Analysis

MeSH terms

  • Antineoplastic Agents* / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Granulocyte Colony-Stimulating Factor / adverse effects
  • Humans
  • Neoplasms* / drug therapy
  • Neoplasms* / etiology
  • Neutropenia* / chemically induced
  • Neutropenia* / drug therapy
  • Neutropenia* / epidemiology
  • Risk

Substances

  • Granulocyte Colony-Stimulating Factor
  • Antineoplastic Agents