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Crit Rev Oncol Hematol. 2011 Jul;79(1):43-50. doi: 10.1016/j.critrevonc.2010.07.001. Epub 2010 Aug 3.

Can first cycle CBCs predict older patients at very low risk of neutropenia during further chemotherapy?

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  • 1Eindhoven Cancer Registry, Department of Research, Eindhoven, The Netherlands. research@ikz.nl


Elderly cancer patients with normal complete blood cell counts (CBCs) during the first course of (some types of) chemotherapy might be unlikely to experience grade 4 neutropenia during subsequent cycles. In this case, further weekly CBCs might be avoided. We used data of 223 cancer patients aged 70+ who were included in the CRASH (Chemotherapy Risk Assessment Score for High-age patients) trial between 2003 and 2007 in 7 cancer practices in the US. First cycle CBC values were compared to subsequent cycles. MAX2-score was used as a measure for toxicity of the chemotherapy regimen. Sixty-two patients (28%) experienced grade 4 neutropenia during subsequent cycles. Among patients who received chemotherapy with a MAX2-score lower than 0.20, only 4.6% of those without neutropenia during the first cycle experienced grade 4 neutropenia during subsequent cycles. Weekly CBC might be avoided in these patients receiving chemotherapy. Future prospective studies should confirm these results.

Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

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