Morimoto Masaya, Yokoya Yuma, Yoshida Kikuaki, Kosako Hideki, Hori Yoshikazu, Mushino Toshiki, Tamura Shinobu, Ito Reiko, Koyamada Ryosuke, Yamashita Takuya, Mori Shinichiro, Mori Nobuyoshi, Ohde Sachiko
Department of Hematology/Oncology, Kinan Hospital, Wakayama 646-8588, Japan.
Department of Hematology/Oncology, Wakayama Medical University, Wakayama 641-8509, Japan.
Hematol Rep. 2024 Feb 7;16(1):76-88. doi: 10.3390/hematolrep16010008.
Febrile neutropenia (FN) is a major concern in patients undergoing chemotherapy for diffuse large B-cell lymphoma (DLBCL); however, the overall risk of FN is difficult to assess. This study aimed to develop a model for predicting the occurrence of FN in patients with DLBCL. In this multicenter, retrospective, observational analysis, a multivariate logistic regression model was used to analyze the association between FN incidence and pretreatment clinical factors. We included adult inpatients and outpatients (aged ≥ 18 years) diagnosed with DLBCL who were treated with chemotherapy. The study examined 246 patients. Considering FN occurring during the first cycle of chemotherapy as the primary outcome, a predictive model with a total score of 5 points was constructed as follows: 1 point each for a positive hepatitis panel, extranodal involvement, and a high level of soluble interleukin-2 receptor and 2 points for lymphopenia. The area under the receiver operating characteristic curve of this model was 0.844 (95% confidence interval: 0.777-0.911). Our predictive model can assess the risk of FN before patients with DLBCL start chemotherapy, leading to better outcomes.
发热性中性粒细胞减少症（FN）是弥漫性大B细胞淋巴瘤（DLBCL）患者化疗过程中的一个主要问题；然而，FN的总体风险难以评估。本研究旨在建立一个预测DLBCL患者发生FN的模型。在这项多中心、回顾性、观察性分析中，采用多变量逻辑回归模型分析FN发生率与预处理临床因素之间的关联。我们纳入了诊断为DLBCL并接受化疗的成年住院患者和门诊患者（年龄≥18岁）。该研究共检查了246例患者。将化疗第一周期期间发生的FN作为主要结局，构建了一个总分为5分的预测模型，具体如下：乙肝检测阳性、结外受累和可溶性白细胞介素-2受体水平高各得1分，淋巴细胞减少得2分。该模型的受试者工作特征曲线下面积为0.844（95%置信区间：0.777 - 0.911）。我们的预测模型可以在DLBCL患者开始化疗前评估FN风险，从而带来更好的治疗结果。
