학술논문
Validation of the CSR FENCE score for prediction of febrile neutropenia during chemotherapy cycles 2–6
Document Type
Original Paper
Author
Source
Discover Oncology. 13(1)
Subject
Language
English
ISSN
2730-6011
Abstract
Purpose: Though febrile neutropenia (FN) risk prediction models are important in clinical practice, their external validation is limited. In this study, we validated the Cycle-Specific Risk of FEbrile Neutropenia after ChEmotherapy (CSR FENCE) score for predicting FN.Methods: We reviewed the medical records of patients with solid malignancies and diffuse large B-cell lymphoma during chemotherapy cycles 2–6 and recorded if patients developed FN, defined as absolute neutrophil counts less than 500 cells/microL with fever more than or equal to 38.2 ℃. The CSR FENCE score was determined by adding the risk factors' coefficients described by the original study; subsequently, the score was used to classify chemotherapy cycles into the following risk groups for developing FN: low, intermediate, high, and very high risk. The discriminatory ability of the score was assessed using area under the receiver operating characteristics curve (AUROCC) and incidence rate ratios (IRR) within each CSR FENCE risk group.Results: We analyzed 2870 chemotherapy cycles, of which 42 (1.5%) were associated with FN. Among those, 3 (7.1%), 14 (33.3%), 5 (12%), and 20 (47.6%) were classified as low, intermediate, high, and very high risk for developing FN, respectively. The AUROCC was 0.72 (95% CI 0.64–0.81). Compared with the low risk group (n = 666), the IRR of developing FN was 1.01 (95% CI 0.15–43.37), 0.69 (95% CI 0.08–32.46) and 1.17 (95% CI 0.17–49.49) in the intermediate (n = 1431), high (n = 498) and very high (n = 275) risk groups, respectively.Conclusion: The CSR FENCE model can moderately stratify patients into four risk groups for predicting FN prior to chemotherapy cycles 2–6.