Pretreatment monocyte counts and neutrophil counts predict the risk for febrile neutropenia in patients undergoing TPF chemotherapy for head and neck squamous cell carcinoma

Marie Shimanuki, Yorihisa Imanishi, Yoichiro Sato, Nana Nakahara, Daisuke Totsuka, Emiri Sato, Sena Iguchi, Yasuo Sato, Keiko Soma, Yasutomo Araki, Seiji Shigetomi, Satoko Yoshida, Kosuke Uno, Yusuke Ogawa, Takehiro Tominaga, Yuichi Ikari, Junko Nagayama, Ayako Endo, Koshiro Miura, Takuya TomiokaHiroyuki Ozawa, Kaoru Ogawa

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Febrile neutropenia (FN) is the most serious hematologic toxicity of systemic chemotherapy. However, accurate prediction of FN development has been difficult because the risk varies largely depending on the chemotherapy regimen and various individual factors. Methods: We retrospectively analyzed diverse clinical factors including pretreatment hematological parameters to clarify the reliable predictors of FN development during chemotherapy with a docetaxel, cisplatin, and fluorouracil (TPF) regimen in patients with head and neck squamous cell carcinoma. Results: Among the 50 patients, grade ≥3 neutropenia, grade 4 neutropenia, and FN developed in 36 (72%), 21 (42%), and 12 (24%) patients, respectively. Multivariate logistic regression revealed that a pretreatment absolute monocyte count (AMC) < 370/mm3 is an independent predictor of TPF chemotherapy-induced FN (odds ratio=6.000, p=0.017). The predictive performance of the model combining AMC and absolute neutrophil count (ANC), in which the high-risk group was defined as having an AMC < 370/mm3 and/or ANC < 3500/mm3, was superior (area under the curve [AUC]=0.745) to that of the model with a cutoff for AMC alone (AUC=0.679). Conclusions: On the basis of our results, we recommend primary prophylactic use of granulocyte colony-stimulating factor and/or antibiotics selectively for patients predicted to be at high risk for TPF chemotherapy-induced FN.

Original languageEnglish
Pages (from-to)18970-18984
Number of pages15
JournalOncotarget
Volume9
Issue number27
DOIs
Publication statusPublished - 2018 Apr 10

Keywords

  • Febrile neutropenia
  • Head and neck squamous cell carcinoma
  • Monocyte count
  • Neutrophil count
  • TPF

ASJC Scopus subject areas

  • Oncology

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