Which one is a risk factor for chemotherapy-induced febrile neutropenia in childhood solid tumors: early lymphopenia or monocytopenia?

Neutropenia is one of the undesirable effects of cancer chemotherapy, sometimes causing life-threatening events. The present study was conducted to identify the risk factors of neutropenia caused by chemotherapy. Between January 2001 and March 2004, a total of 77 children with 165 neutropenic attacks were enrolled in this study. Complete blood count was performed before chemotherapy and on days 1, 3, 5, 7, and 9 consecutively. The complete blood count results of the febrile neutropenia (FN) group were compared to those of the non-FN group. The incidence of FN was significantly higher in patients with ANC counts < or =0.5 x 10(9)/L on days 3, 5, and 7, lymphocyte counts < or =0.5 x 10(9)/L on days 7 and 9, < or =0.7 x 10(9)/L on days 5, 7, and 9, and with monocyte counts < or =0.15 x 10(9)/L on days 7 and 9, respectively. Further statistical analysis showed that lymphocyte count < or =0.7 x 10(9)/L on day 5, and monocyte count < or =0.15 x 10(9)/L on day 7 were independent risk factors for FN. The authors conclude that lymphocyte counts on the 5th day can be more a predictive factor than monocyte count.