The Impact of Age on Delivered Dose Intensity and Hospitalizations for Febrile Neutropenia in Patients with Intermediate-Grade Non-Hodgkin's Lymphoma Receiving Initial CHOP Chemotherapy: A Risk Factor Analysis

Morrison, Vicki A.; Picozzi, Vincent J.; Scott, Shelley A.; Pohlman, Brad; Dickman, Elliot; Lee, Martin; Lawless, Grant; Kerr, Robert O.; Caggiano, Vincent; Delgado, David; Fridman, Moshe; Ford, Jon M.; Carter, William B.

doi:10.3816/clm.2001.n.011

Cited by 132 publications

(89 citation statements)

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“…7,10 The characteristics associated with a significantly increased risk of hospitalization resulting from febrile neutropenia in these patients included age 65 years or older, a greater than 80% planned ARDI, renal disease, and no early G-CSF administration. 8 In the current study, age 65 years or older was also associated with an increased risk of hospitalization for febrile neutropenia. Longer lengths of stay and increased mortality rates have been associated with hospitalizations for older patients, possibly because of comorbidities that are more common among the elderly.…”

Section: Discussionmentioning

confidence: 45%

“…The finding that the majority of initial hospitalizations for febrile neutropenia occur within the first 2 cycles of chemotherapy is consistent with a previous study in which 83% of these events occurred by Cycle 3. 8 The early time of onset is important because of the potential impact of resulting treatment delays or dose reductions on the overall dose intensity in patients with responsive and potentially curable malignancies such as NHL. 15,17,18 These concerns are further confirmed by recent data, suggesting that patients hospitalized for febrile neutropenia in Cycle 1 were 4.4 times more likely to prematurely discontinue CHOP chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…Based on previous research, the following characteristics were predicted to be associated with a higher risk of hospitalization for febrile neutropenia: age 65 years or older, female gender, BSA less than 2.0 m 2 , advanced-stage disease, LDH level greater than 300 U/L, albumin level less than or equal to 3.5 g/dL, presence of bone marrow involvement, and ANC less than 1500/mm 3 . 7,8,10 …”

Section: Independent Variables and Operational Definitionsmentioning

confidence: 99%

“…In addition, previous risk modeling studies have suggested an association between greater than 80% ARDI and increased risk of a febrile neutropenic event. 8,9 Hospitalization for febrile neutropenia was determined from the patient's medical record. Time to first hospitalization for febrile neutropenia was defined as the number of days from the start of Cycle 1 chemotherapy to the day that the first hospitalization for febrile neutropenia occurred.…”

Section: Treatment Characteristics and Outcomesmentioning

confidence: 99%

“…In addition, to our knowledge, none of these models have been validated. [7][8][9][10][11] Furthermore, previous risk modeling efforts have provided limited information regarding the risk and timing of the first hospitalization for febrile neutropenia.…”

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confidence: 99%

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Risk and timing of hospitalization for febrile neutropenia in patients receiving CHOP, CHOP‐R, or CNOP chemotherapy for intermediate‐grade non‐Hodgkin lymphoma

Lyman

Delgado

2003

Cancer

171

111

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BACKGROUNDHospitalization for chemotherapy‐induced febrile neutropenia is associated with substantial cost and may negatively impact clinical outcome due to associated dose attenuation.METHODSMedical records of 1355 patients with intermediate‐grade non‐Hodgkin lymphoma receiving cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or similar chemotherapy were reviewed. The potential risk factors associated with first hospitalization for febrile neutropenia were evaluated.RESULTSIn the current study, 230 patients (17%) experienced 1 or more hospitalizations for febrile neutropenia and greater than one‐half of all initial hospitalizations for febrile neutropenia occurred in Cycles 1 or 2. Increased risk of hospitalization for febrile neutropenia, based on Cox proportional hazards models, was significantly associated with the following characteristics: age 65 years or older (hazard ratio [HR] = 1.79; 95% confidence interval [95% CI], 1.35–2.37), serum albumin level at presentation less than or equal to 3.5 g/dL (HR = 1.34; 95% CI, 1.01–1.78), planned average relative dose intensity greater than or equal to 80% (HR = 2.70; 95% CI, 1.47–4.98), baseline absolute neutrophil count less than 1500/mm3 (HR = 1.98; 95% CI, 1.28–3.06), and the presence of hepatic disease (HR = 2.18; 95% CI, 1.11–4.28). Lack of early granulocyte colony‐stimulating factor in Cycles 1 and 2 was also associated with increased risk of hospitalization for febrile neutropenia, but this did not reach statistical significance. A composite risk score based on these potential risk factors effectively distinguished patients at greater risk of hospitalization for febrile neutropenia (P < 0.001), the majority of which were observed during the first cycle of chemotherapy.CONCLUSIONSThe data from the current study demonstrated that the risk of initial hospitalization for febrile neutropenia occured early in the course of CHOP‐like chemotherapy. Identified risk factors for febrile neutropenia hospitalization may facilitate the use of targeted supportive care. Cancer 2003. © 2003 American Cancer Society.

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Section: Discussionmentioning

confidence: 45%

Section: Discussionmentioning

confidence: 99%

Section: Independent Variables and Operational Definitionsmentioning

confidence: 99%

Section: Treatment Characteristics and Outcomesmentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Risk and timing of hospitalization for febrile neutropenia in patients receiving CHOP, CHOP‐R, or CNOP chemotherapy for intermediate‐grade non‐Hodgkin lymphoma

Lyman

Delgado

2003

Cancer

171

111

View full text Add to dashboard Cite

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Chemotherapy in Older Adults with Cancer

Aapro

Wildiers

2012

Cancer and Aging Handbook

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Scaling functions of polymer‐induced turbulent drag reduction focusing on the polymer–solvent interaction

Kim

Choi

2003

J of Applied Polymer Sci

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Based on turbulent drag reduction characteristics of polystyrene and polyisobutylene in a pipe flow and a rotating-disk flow, respectively, a relationship between polymer concentration and drag reduction at a given Reynolds number was considered. The universal drag reduction equation of a three-parameter relationship between drag reduction and polymer concentration was modified using intrinsic concentration and intrinsic viscosity, and it was then found to be the most useful formula for correlating DR data, especially for polymer-solvent interactions in a turbulent flow. Key words: drag reduction; intrinsic viscosity; polymersolvent interaction; polystyrene; polyisobutyleneThe addition of small amounts of high molecular weight polymers (typically on the order of parts per million) to a turbulent flow can yield a drastic increase in the mass flow at a given pressure gradient. The drag reduction (DR) is defined as the amount of the reduction in the skin-frictional drag. Polymer-induced DR has been the subject of numerous theoretical and experimental studies, but despite these efforts, the details of the underlying physical and chemical mechanisms of DR have not fully been investigated. DR is known to be strongly influenced by the molecular properties of the dissolved polymer. We introduce a universal scaling function that describes DR correlation by focusing on the effects of the polymer molecular parameters and solvent quality. DR efficiency can be described through a consideration of the critical concentration above which no DR will occur.The purpose of this work is to examine the relationship between the polymer concentration (C) and DR at a given Reynolds number. We examine the effects of the polymer molecular parameters and solvent quality on DR, this being useful for unifying the DR correlation.The concentration-dependent DR profile was historically examined by Virk et al. 1 and Little and coworkers.2,3 Virk et al. developed the first universal DR relationship through a homologous series of poly(ethylene oxide) (PEO) in water as a function of the concentration, molecular weight, and flow rate in the internal flow. Later, Little and coworkers 2,3 simplified and rearranged this universal relationship, correlating

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The Impact of Age on Delivered Dose Intensity and Hospitalizations for Febrile Neutropenia in Patients with Intermediate-Grade Non-Hodgkin's Lymphoma Receiving Initial CHOP Chemotherapy: A Risk Factor Analysis

Cited by 132 publications

References 44 publications

Risk and timing of hospitalization for febrile neutropenia in patients receiving CHOP, CHOP‐R, or CNOP chemotherapy for intermediate‐grade non‐Hodgkin lymphoma

Risk and timing of hospitalization for febrile neutropenia in patients receiving CHOP, CHOP‐R, or CNOP chemotherapy for intermediate‐grade non‐Hodgkin lymphoma

Chemotherapy in Older Adults with Cancer

Scaling functions of polymer‐induced turbulent drag reduction focusing on the polymer–solvent interaction

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