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首页> 外文期刊>BMC Cancer >Multivariable regression analysis of febrile neutropenia occurrence in early breast cancer patients receiving chemotherapy assessing patient-related, chemotherapy-related and genetic risk factors
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Multivariable regression analysis of febrile neutropenia occurrence in early breast cancer patients receiving chemotherapy assessing patient-related, chemotherapy-related and genetic risk factors

机译：接受化疗的早期乳腺癌患者发热性中性粒细胞减少症发生的多变量回归分析，评估患者相关，化疗相关和遗传危险因素

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Background Febrile neutropenia (FN) is common in breast cancer patients undergoing chemotherapy. Risk factors for FN have been reported, but risk models that include genetic variability have yet to be described. This study aimed to evaluate the predictive value of patient-related, chemotherapy-related, and genetic risk factors. Methods Data from consecutive breast cancer patients receiving chemotherapy with 4–6?cycles of fluorouracil, epirubicin, and cyclophosphamide (FEC) or three cycles of FEC and docetaxel were retrospectively recorded. Multivariable logistic regression was carried out to assess risk of FN during FEC chemotherapy cycles. Results Overall, 166 (16.7%) out of 994 patients developed FN. Significant risk factors for FN in any cycle and the first cycle were lower platelet count (OR?=?0.78 [0.65; 0.93]) and haemoglobin (OR?=?0.81 [0.67; 0.98]) and homozygous carriers of the rs4148350 variant T-allele (OR?=?6.7 [1.04; 43.17]) in MRP1 . Other significant factors for FN in any cycle were higher alanine aminotransferase (OR?=?1.02 [1.01; 1.03]), carriers of the rs246221 variant C-allele (OR?=?2.0 [1.03; 3.86]) in MRP1 and the rs351855 variant C-allele (OR?=?2.48 [1.13; 5.44]) in FGFR4 . Lower height (OR?=?0.62 [0.41; 0.92]) increased risk of FN in the first cycle. Conclusions Both established clinical risk factors and genetic factors predicted FN in breast cancer patients. Prediction was improved by adding genetic information but overall remained limited. Internal validity was satisfactory. Further independent validation is required to confirm these findings.
机译：背景热中性白细胞减少症（FN）在接受化疗的乳腺癌患者中很常见。 FN的危险因素已有报道，但包括遗传变异性在内的危险模型尚待描述。这项研究旨在评估患者相关，化学疗法相关和遗传危险因素的预测价值。方法回顾性记录连续4-6周期的氟尿嘧啶，表柔比星和环磷酰胺（FEC）或3周期的FEC和多西他赛接受化疗的乳腺癌患者的数据。进行多变量logistic回归以评估FEC化疗周期中FN的风险。结果总体上，994例患者中有166例（16.7％）发展为FN。任一周期和第一个周期中FN的重要危险因素是血小板计数较低（ORα=？0.78 [0.65; 0.93]）和血红蛋白（ORα=？0.81 [0.67; 0.98]）和rs4148350变体T的纯合子携带者-M等位基因中的α-等位基因（ORα＝α6.7[1.04; 43.17]）。在任何周期中，FN的其他重要因素是丙氨酸氨基转移酶较高（ORα=？1.02 [1.01; 1.03]），MRP1中的rs246221变异C等位基因的载体（ORα=？2.0 [1.03; 3.86]）和rs351855。 FGFR4中的C变体等位基因（ORα=？2.48 [1.13; 5.44]）。较低的身高（ORα=？0.62 [0.41; 0.92]）会增加第一个周期的FN风险。结论既定的临床危险因素和遗传因素均能预测乳腺癌患者的FN。通过添加遗传信息改善了预测，但总体上仍然有限。内部有效性令人满意。需要进一步的独立验证来确认这些发现。

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