Division of Urology, Department of General Surgery and Urology, Faculty of Medicine, Jordan University of Science & Technology, Irbid 22110, Jordan.
Faculty of Medicine, Jordan University of Science & Technology, Irbid 22110, Jordan.
Medicina (Kaunas). 2022 Oct 24;58(11):1508. doi: 10.3390/medicina58111508.
Chemotherapy-induced febrile neutropenia is the most widespread oncologic emergency with high morbidity and mortality rates. Herein we present a retrospective risk factor identification study to evaluate the prognostic role of lymphocyte-based measures and ratios in a cohort of chemotherapy-induced febrile neutropenia patients following granulocyte colony-stimulating factor (G-CSF) therapy. : The electronic medical records at our center were utilized to identify patients with a first attack of chemotherapy-induced febrile neutropenia and were treated accordingly with G-CSF between January 2010 to December 2020. Patients' demographics and disease characteristics along with laboratory tests data were extracted. Prognosis-related indicators were the absolute neutrophil count (ANC) at admission and the following 6 days besides the length of stay and mortality rate. : A total of 80 patients were enrolled, which were divided according to the absolute lymphocyte count at admission into two groups, the first includes lymphopenia patients ( = 55) and the other is the non-lymphopenia group ( = 25) with a cutoff point of 700 lymphocytes/μL. Demographics and baseline characteristics were generally insignificant among the two groups but the white blood cell count was higher in the non-lymphopenia group. ANC, neutrophils percentage and ANC difference in reference to admission among the two study groups were totally insignificant. The same insignificant pattern was observed in the length of stay and the mortality rate. Univariate analysis utilizing the ANC difference compared to the admission day as the dependent variable, revealed no predictability role in the first three days of follow up for any of the variables included. However, during the fourth day of follow up, both WBC (OR = 0.261; 95% CI: 0.075, 0.908; = 0.035) and lymphocyte percentage (OR = 1.074; 95% CI: 1.012, 1.141; = 0.019) were marginally significant, in which increasing WBC was associated with a reduction in the likelihood of ANC count increase, compared to the lymphocyte percentage which exhibited an increase in the likelihood. In comparison, sequential ANC difference models demonstrated lymphocyte percentage (OR = 0.961; 95% CI: 0.932, 0.991; = 0.011) and monocyte-to-lymphocyte ratio (OR = 7.436; 95% CI: 1.024, 54.020; = 0.047) reduction and increment in the enhancement of ANC levels, respectively. The fifth day had WBC (OR = 0.790; 95% CI: 0.675, 0.925; = 0.003) to be significantly decreasing the likelihood of ANC increment. we were unable to determine any concrete prognostic role of lymphocyte-related measures and ratios. It is plausible that several limitations could have influenced the results obtained, but as far as our analysis is concerned ALC role as a predictive factor for ANC changes remains questionable.
化疗引起的发热性中性粒细胞减少症是最常见的肿瘤急症，发病率和死亡率都很高。在此，我们进行了一项回顾性危险因素识别研究，以评估在接受粒细胞集落刺激因子（G-CSF）治疗后，一组化疗引起的发热性中性粒细胞减少症患者的淋巴细胞为基础的指标和比值的预后作用。
我们利用中心的电子病历，确定了 2010 年 1 月至 2020 年 12 月期间首次发生化疗引起的发热性中性粒细胞减少症并接受 G-CSF 治疗的患者。提取了患者的人口统计学和疾病特征以及实验室检查数据。预后相关指标为入院时和入院后第 6 天的绝对中性粒细胞计数（ANC）以及住院时间和死亡率。
共纳入 80 例患者，根据入院时的绝对淋巴细胞计数分为两组，第一组包括淋巴细胞减少症患者（=55 例）和非淋巴细胞减少症组（=25 例），截断值为 700 个淋巴细胞/μL。两组的人口统计学和基线特征一般无显著差异，但非淋巴细胞减少症组的白细胞计数较高。两组研究的 ANC、中性粒细胞百分比和 ANC 与入院时的差异均无显著差异。住院时间和死亡率也呈现出相同的无显著性模式。利用 ANC 与入院日的差异作为因变量的单变量分析显示，在随访的前三天，包括的任何变量均无预测作用。然而，在第四天的随访中，白细胞（OR=0.261；95%CI：0.075，0.908；=0.035）和淋巴细胞百分比（OR=1.074；95%CI：1.012，1.141；=0.019）均具有边际显著性，其中白细胞的增加与 ANC 计数增加的可能性降低有关，而淋巴细胞百分比的增加与 ANC 计数增加的可能性增加有关。相比之下，连续 ANC 差异模型显示淋巴细胞百分比（OR=0.961；95%CI：0.932，0.991；=0.011）和单核细胞/淋巴细胞比值（OR=7.436；95%CI：1.024，54.020；=0.047）分别降低和增加 ANC 水平的增强。第五天白细胞（OR=0.790；95%CI：0.675，0.925；=0.003）显著降低 ANC 增加的可能性。我们无法确定淋巴细胞相关指标和比值的具体预后作用。有几个限制因素可能会影响到研究结果，但就我们的分析而言，ALC 作为 ANC 变化的预测因子的作用仍然存在疑问。
