Chemotherapy-induced neutropenia as a prognostic and predictive marker of outcomes in solid-tumor patients
Abstract
Chemotherapy-induced neutropenia (CIN) is one of the most common side effects seen in cancer patients. As an adverse event, it is deemed undesirable since it often constitutes a dose-limiting toxicity for cytotoxic agents leading to treatment delays and/or dose reductions. It is also associated with a financial cost component from diagnostic work-up and treatment of patients with chemotherapy-induced febrile neutropenia (CIFN). Neutropenia is commonly accompanied by a decrease in other hematopoietic lineages (anemia and/or thrombocytopenia). Dosing of chemotherapeutic agents is based on the severity of adverse effects seen. Depending on the degree of neutropenia, chemotherapeutic agents may be put on hold until count recovery and growth factor support might be added to allow for dosing as scheduled. However, neutropenia appears to be more than just an adverse event. While CIFN by itself constitutes an adverse event, the appearance of just CIN is not necessarily a marker of poor outcome. In fact, it rather appears to be a surrogate marker of response and/or survival in patients treated with cytotoxic regimens. Here we present evidence in different tumor types treated with different regimens on the role CIN plays as a marker for improved outcomes. If CIN is a surrogate prognostic and/or potentially predictive marker of response, chemotherapy doses may need to be escalated to achieve neutropenia. In addition, instead of reducing treatment doses for safety concerns, the addition of growth factor support and alternative dosing schemes may be strategies to consider.
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Chemotherapy-induced neutropenia has predicted improved survival rates among cancer patients.
“chemotherapy induced neutropenia has also predicted improved survival rates among cancer patients [12–17]”
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- Authors
- Kasi, P. M., & Grothey, A.
- Affiliations
- Mayo Clinic in Florida (US)
- Mayo Clinic (US)
- Corresponding author
- Grothey, Axel
- Venue
- Drugs
- Published
- 2018-05
- Volume
- 78
- Issue
- 7
- Pages
- 737-745
- ISSN
- 0012-6667 (ISSN-L)
- 1179-1950
- OpenAlex
- W2801136696
- Cited by
- 80
- References
- 81
- Citations by year
- 2026: 6 · 2025: 14 · 2024: 10 · 2023: 15 · 2022: 18 · 2021: 9 · 2020: 6 · 2019: 2
- FWCI
- 0.44
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Drugs (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Neutropenia and Cancer Infections
- Health Sciences › Medicine › Oncology › Inflammatory Biomarkers in Disease Prognosis
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Blood disorders and treatments
- Keywords
- chemotherapy-induced neutropenia, solid tumors, prognostic factors, predictive biomarkers, treatment response, survival, dose-limiting toxicity, growth factor support, chemotherapy dosing, hematologic adverse events
- MeSH terms
- Antineoplastic Agents, Humans, Neoplasms, Neutropenia, Prognosis, Outcome Assessment, Health Care, Induction Chemotherapy
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