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Identification of patients at risk for early death after conventional chemotherapy in solid tumours and lymphomas

1–5% of cancer patients treated with cytotoxic chemotherapy die within a month after the administration of chemotherapy. Risk factors for these early deaths (ED) are not well known. The purpose of this study was to establish a risk model for ED after chemotherapy applicable to all tumour types. The...

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Autores principales: Ray-Coquard, I, Ghesquière, H, Bachelot, T, Borg, C, Biron, P, Sebban, C, LeCesne, A, Chauvin, F, Blay, J-Y
Formato: Texto
Lenguaje:English
Publicado: Nature Publishing Group 2001
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2375083/
https://www.ncbi.nlm.nih.gov/pubmed/11556830
http://dx.doi.org/10.1054/bjoc.2001.2011
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author Ray-Coquard, I
Ghesquière, H
Bachelot, T
Borg, C
Biron, P
Sebban, C
LeCesne, A
Chauvin, F
Blay, J-Y
author_facet Ray-Coquard, I
Ghesquière, H
Bachelot, T
Borg, C
Biron, P
Sebban, C
LeCesne, A
Chauvin, F
Blay, J-Y
author_sort Ray-Coquard, I
collection PubMed
description 1–5% of cancer patients treated with cytotoxic chemotherapy die within a month after the administration of chemotherapy. Risk factors for these early deaths (ED) are not well known. The purpose of this study was to establish a risk model for ED after chemotherapy applicable to all tumour types. The model was delineated in a series of 1051 cancer patients receiving a first course of chemotherapy in the Department of Medicine of the Centre Léon Bérard (CLB) in 1996 (CLB-1996 cohort), and then validated in a series of patients treated in the same department in 1997 (CLB-1997), in a prospective cohort of patients with aggressive non-Hodgkin's lymphoma (NHL) (CLB-NHL), and in a prospective cohort of patients with metastatic breast cancer (MBC series) receiving first-line chemotherapy. In the CLB-1996 series, 43 patients (4.1%) experienced early. In univariate analysis, age > 60, PS > 1, lymphocyte (ly) count ≤ 700 μl(−1) immediately prior to chemotherapy (d1), d1-platelet count ≤ 150 Gl(−1), and the type of chemotherapy were significantly correlated to the risk of early death (P ≤ 0.01). Using logistic regression, PS > 1 (hazard ratio 3.9 (95% Cl 2.0–7.5)) and d1-ly count ≤ 700 μl(−1) (3.1 (95% Cl 1.6–5.8)) were identified as independent risk factors for ED. The calculated probability of ED was 20% (95% Cl 10–31) in patients with both risk factors, 6% (95% Cl 4–9) for patients with only 1 risk factor, and 1.7% (95% Cl 0.9–3) for patients with none of these 2 risk factors. In the CLB-97, CLB-NHL and MBC validation series, the observed incidences of early death in patients with both risk factors were 19%, 25% and 40% respectively and did not differ significantly from those calculated in the model. In conclusion, poor performance status and lymphopenia identify a subgroup of patients at high risk for early death after chemotherapy. © 2001 Cancer Research Campaignhttp://www.bjcancer.com
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spelling pubmed-23750832009-09-10 Identification of patients at risk for early death after conventional chemotherapy in solid tumours and lymphomas Ray-Coquard, I Ghesquière, H Bachelot, T Borg, C Biron, P Sebban, C LeCesne, A Chauvin, F Blay, J-Y Br J Cancer Regular Article 1–5% of cancer patients treated with cytotoxic chemotherapy die within a month after the administration of chemotherapy. Risk factors for these early deaths (ED) are not well known. The purpose of this study was to establish a risk model for ED after chemotherapy applicable to all tumour types. The model was delineated in a series of 1051 cancer patients receiving a first course of chemotherapy in the Department of Medicine of the Centre Léon Bérard (CLB) in 1996 (CLB-1996 cohort), and then validated in a series of patients treated in the same department in 1997 (CLB-1997), in a prospective cohort of patients with aggressive non-Hodgkin's lymphoma (NHL) (CLB-NHL), and in a prospective cohort of patients with metastatic breast cancer (MBC series) receiving first-line chemotherapy. In the CLB-1996 series, 43 patients (4.1%) experienced early. In univariate analysis, age > 60, PS > 1, lymphocyte (ly) count ≤ 700 μl(−1) immediately prior to chemotherapy (d1), d1-platelet count ≤ 150 Gl(−1), and the type of chemotherapy were significantly correlated to the risk of early death (P ≤ 0.01). Using logistic regression, PS > 1 (hazard ratio 3.9 (95% Cl 2.0–7.5)) and d1-ly count ≤ 700 μl(−1) (3.1 (95% Cl 1.6–5.8)) were identified as independent risk factors for ED. The calculated probability of ED was 20% (95% Cl 10–31) in patients with both risk factors, 6% (95% Cl 4–9) for patients with only 1 risk factor, and 1.7% (95% Cl 0.9–3) for patients with none of these 2 risk factors. In the CLB-97, CLB-NHL and MBC validation series, the observed incidences of early death in patients with both risk factors were 19%, 25% and 40% respectively and did not differ significantly from those calculated in the model. In conclusion, poor performance status and lymphopenia identify a subgroup of patients at high risk for early death after chemotherapy. © 2001 Cancer Research Campaignhttp://www.bjcancer.com Nature Publishing Group 2001-09 /pmc/articles/PMC2375083/ /pubmed/11556830 http://dx.doi.org/10.1054/bjoc.2001.2011 Text en Copyright © 2001 Cancer Research Campaign https://creativecommons.org/licenses/by/4.0/This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material.If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/.
spellingShingle Regular Article
Ray-Coquard, I
Ghesquière, H
Bachelot, T
Borg, C
Biron, P
Sebban, C
LeCesne, A
Chauvin, F
Blay, J-Y
Identification of patients at risk for early death after conventional chemotherapy in solid tumours and lymphomas
title Identification of patients at risk for early death after conventional chemotherapy in solid tumours and lymphomas
title_full Identification of patients at risk for early death after conventional chemotherapy in solid tumours and lymphomas
title_fullStr Identification of patients at risk for early death after conventional chemotherapy in solid tumours and lymphomas
title_full_unstemmed Identification of patients at risk for early death after conventional chemotherapy in solid tumours and lymphomas
title_short Identification of patients at risk for early death after conventional chemotherapy in solid tumours and lymphomas
title_sort identification of patients at risk for early death after conventional chemotherapy in solid tumours and lymphomas
topic Regular Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2375083/
https://www.ncbi.nlm.nih.gov/pubmed/11556830
http://dx.doi.org/10.1054/bjoc.2001.2011
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