1486PD - Prognostic evaluation of clinically stable febrile neutropenia: prospective data from 921 patients from the FINITE study

Date 29 September 2014
Event ESMO 2014
Session Supportive and palliative care
Topics Supportive Care
Presenter Paula Fonseca
Citation Annals of Oncology (2014) 25 (suppl_4): iv517-iv541. 10.1093/annonc/mdu356
Authors P.J. Fonseca1, A. Carmona-Bayonas2, C. Font3, M. Antonio Rebollo4, A. Ramchandani5, J. Hernando Cubero6, J. Espinosa7, E.M. De Castro8, I. Ghanem9, J. Martínez10, C. Beato11, J. Virizuela12, A. Blasco13, Y. Bonilla14, A. Manzano15, E. Castañon16, E. Sevillano17, M.A. Vicente Conesa2, F.A. De La Peña2
  • 1Medical Oncology, Hospital Universitario Central de Asturias, 33006 - Oviedo/ES
  • 2Medical Oncology/hematology, Hospital Universitario Morales Meseguer, 30008 - Murcia/ES
  • 3Medical Oncology, Hospital Universitario Clinic, Barcelona/ES
  • 4Medical Oncology, ICO Duran i Reynals, Barcelona/ES
  • 5Medical Oncology, Hospital de Las Palmas, Las Palmas/ES
  • 6Medical Oncology, Hospital Universitario Miguel Servet, Zaragoza/ES
  • 7Medical Oncology, Hospital General Universitario de Ciudad Real, Ciudad Real/ES
  • 8Medical Oncology, Hospital Universitario Marques de Valdecilla, Santander/ES
  • 9Medical Oncology, Hospital Universitario La Paz, Madrid/ES
  • 10Medical Oncology, Hospital Universitario Virgen de la Arrixaca, Murcia/ES
  • 11Medical Oncology, Hospital NISA, Sevilla/ES
  • 12Medical Oncology, Hospital Universitario Virgen Macarena, 41007 - Sevilla/ES
  • 13Medical Oncology, Hospital General Universitario de Valencia, 46014 - Valencia/ES
  • 14Medical Oncology, Hospital de Santa Lucía, 30202 - Santa Lucia Cartagena/ES
  • 15Medical Oncology, Hospital Universitario San Carlos, 38040 - Madrid/ES
  • 16Medical Oncology, Clinica Universitaria de Navarra, 31008 - Pamplona/ES
  • 17Medical Oncology, Hospital Universitario Son Espases, 07120 - Palma de Mallorca/ES

Abstract

Aim

In the present study, we aimed to assess the prognostic factors and outcomes of apparently stable febrile neutropenia (ASFN) episodes.

Methods

FINITE is a prospective, multicenter study to assess prognostic factors and patterns of care in patients with ASFN defined by the absence of hemodynamic instability, acute organ failure, specific sources of infection (e.g. pneumonia) or inability to take oral medication. We used a binary logistic regression model with bootstrap resampling to identify prognostic factors for serious complications in stable patients.

Results

From Sep/12 to Mar/14, 921 patients with ASFN were included from 24 centers. The rates of serious complicatios and mortality were:14.6% (95%CI, 12.5 to 17%) and 2.1% (95%CI, 1.4 to 3.3%). Signifficant clinical and microbiological differences were observed in patients with or without complications. In the multivariate analysis, nine variables were independent risk factors for serious complications: European Cooperative Oncology Group performance status >1, cardiovascular disease, chronic obstructive pulmonary disease, mucositis NCI grade >1, monocytes <200/mm3, lymphocytes <450/mm3, rigors, treatment with corticoids and malnutrition (table 1).

Multivariate and bootstrap analysis of risk factors for serious complications

Parameter Coeff. OR 95% CI p-value
ECOG ≥2 1.39 4 1.33-3.37 0.001
Cardiovascular disease 0.81 2.2 1.15-4.47 0.01
COPD 1.01 2.7 1.68-6.77 0.001
Mucositis ≥2 1.08 2.9 1.78-4.96 0.001
Monocytes <200/mm3 0.99 2.6 1.66-4.96 0.001
Lymphocytes 450/mm3 0.85 2.3 1.45-4.1 0.002
Rigors 0.75 2.1 1.33-3.37 0.002
Previous treatment with corticoids 0.71 2 1.05-3.95 0.02
Malnutrition 1.20 3.3 1.68-6.46 0.01

Conclusions

This study identified risk factors for serious complications in patients with solid cancers and ASFN episodes, with potential implications on individualized therapy.

Disclosure

All authors have declared no conflicts of interest.