Predictors of the development of febrile neutropenia in chemotherapy for advanced germ cell tumors

• Published in: International journal of urology Vol. 31; no. 2; pp. 134 - 138
• Main Authors: Kobayashi, Kota, Kishida, Takeshi
• Format: Journal Article
• Language: English
• Published: Australia Wiley Subscription Services, Inc 01.02.2024
• Subjects: Chemotherapy; Colony-stimulating factor; Creatinine; febrile neutropenia; germ cell tumor; Leukocytes (granulocytic); Metastases; Multivariate analysis; Neutropenia; predictive factors; Renal function; Risk factors; Statistical analysis; testicular tumor; Tumors; febrile neutropenia; chemotherapy; germ cell tumor; predictive factors; testicular tumor
• ISSN: 0919-8172; 1442-2042
• DOI: 10.1111/iju.15323

Objectives To identify the predictive factors for the development of febrile neutropenia (FN) in the course of chemotherapy for patients with germ cell tumors. Methods From January 2005 to December 2018, 80 patients were treated with induction chemotherapy for advanced germ cell tumors at Kanagawa Cancer Center Hospital, Japan. Of these, we retrospectively analyzed 267 cycles of chemotherapy. The incidence of FN was used as the objective variable. As predictive factors, we analyzed age, international germ cell consensus classification (IGCCC), laboratory data at the start of chemotherapy in each cycle, length of the largest metastatic lesion, number of cycles, and prophylactic use of granulocyte colony stimulating factor (G‐CSF). Results We finally analyzed 267 cycles in 78 patients. The median age was 36 years (15–64). There was a total of 267 cycles. FN occurred in 40 cycles (15%) in 31 patients (40%). The first cycle was accompanied by a significantly higher FN than the subsequent cycles (p < 0.001). The univariate analysis identified age ≧36 years (p = 0.001), creatinine clearance (CCr) <70 (p < 0.001), serum albumin <3.3 (p = 0.002), maximum tumor diameter ≧60 mm (p = 0.036), and first cycle as significant risk factors. The multivariate analysis identified age, CCr, and first cycle as independent predictive factors of FN development. Conclusion We identified older age, renal dysfunction, and first cycle of chemotherapy as predictive factors for FN. No statistically significant difference was shown in the usage of prophylactic G‐CSF. Special attention should be given to FN in patients with high‐risk factors.