Multivariable regression analysis of febrile neutropenia occurrence in early breast cancer patients receiving chemotherapy assessing patient-related, chemotherapy-related and genetic risk factorsReport as inadecuate




Multivariable regression analysis of febrile neutropenia occurrence in early breast cancer patients receiving chemotherapy assessing patient-related, chemotherapy-related and genetic risk factors - Download this document for free, or read online. Document in PDF available to download.

BMC Cancer

, 14:201

Epidemiology, prevention and public health

Abstract

BackgroundFebrile neutropenia FN is common in breast cancer patients undergoing chemotherapy. Risk factors for FN have been reported, but risk models that include genetic variability have yet to be described. This study aimed to evaluate the predictive value of patient-related, chemotherapy-related, and genetic risk factors.

MethodsData from consecutive breast cancer patients receiving chemotherapy with 4–6 cycles of fluorouracil, epirubicin, and cyclophosphamide FEC or three cycles of FEC and docetaxel were retrospectively recorded. Multivariable logistic regression was carried out to assess risk of FN during FEC chemotherapy cycles.

ResultsOverall, 166 16.7% out of 994 patients developed FN. Significant risk factors for FN in any cycle and the first cycle were lower platelet count OR = 0.78 0.65; 0.93 and haemoglobin OR = 0.81 0.67; 0.98 and homozygous carriers of the rs4148350 variant T-allele OR = 6.7 1.04; 43.17 in MRP1. Other significant factors for FN in any cycle were higher alanine aminotransferase OR = 1.02 1.01; 1.03, carriers of the rs246221 variant C-allele OR = 2.0 1.03; 3.86 in MRP1 and the rs351855 variant C-allele OR = 2.48 1.13; 5.44 in FGFR4. Lower height OR = 0.62 0.41; 0.92 increased risk of FN in the first cycle.

ConclusionsBoth established clinical risk factors and genetic factors predicted FN in breast cancer patients. Prediction was improved by adding genetic information but overall remained limited. Internal validity was satisfactory. Further independent validation is required to confirm these findings.

KeywordsMultivariable analysis Febrile neutropenia Breast neoplasms Chemotherapy Genetics Single nucleotide polymorphism AbbreviationsALTAlanine aminotransferase

ANCAbsolute neutrophil count

ASTAspartate aminotransferase

BMIBody mass index

BSABody surface area

CIConfidence interval

CINChemotherapy-induced neutropenia

EORTCEuropean Organisation for Research and Treatment of Cancer

FDRFalse discovery rate

FECFluorouracil, epirubicin and cyclophosphamide

FNFebrile neutropenia

FGFRFibroblast growth factor receptor

GCSFGranulocyte colony-stimulating factor

MRP1Multidrug resistance-associated protein 1

NPINottingham Prognostic Index

NPVNegative predictive value

OROdds ratio

PPVPositive predictive value

ROCReceiver operating characteristic

SNPSingle nucleotide polymorphism

WBCWhite blood cell count.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2407-14-201 contains supplementary material, which is available to authorized users.

Alena M Pfeil, Christof Vulsteke contributed equally to this work.

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Author: Alena M Pfeil - Christof Vulsteke - Robert Paridaens - Anne-Sophie Dieudonné - Ruth Pettengell - Sigrid Hatse - Patrick N

Source: https://link.springer.com/







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