» Articles » PMID: 35689801

Validation of the FENCE Risk Groups for Prediction of Febrile Neutropenia With First-Cycle Chemotherapy

Overview
Specialty Oncology
Date 2022 Jun 11
PMID 35689801
Authors
Affiliations
Soon will be listed here.
Abstract

Background: The FEbrile Neutropenia after ChEmotherapy (FENCE) score was developed to estimate the risk of febrile neutropenia (FN) at first cycle of chemotherapy but has not been externally validated. We aimed to validate the FENCE score based on its risk groups in patients treated at a comprehensive cancer center.

Methods: We conducted a retrospective study of treatment-naïve adult patients with solid tumors and diffuse large B-cell lymphoma who received first-cycle chemotherapy between January and November 2019. Patients were followed until the second cycle of chemotherapy to identify any FN events (neutrophil count <0.5 × 109/L with fever ≥38.2°C). The FENCE score was determined and patients classified as low, intermediate, high, and very high risk. The discriminatory ability of classifying patients into FENCE risk groups was calculated as the area under the receiver operating characteristics curve and incidence rate ratios within each FENCE risk group.

Results: FN was documented during the first cycle of chemotherapy in 45 of the 918 patients included (5%). The area under the receiver operating characteristics curve was 0.66 (95% confidence interval [CI] = 0.58 to 0.73). Compared with the low-risk group (n = 285), the incidence rate ratio of developing FN was 1.58 (95% CI = 0.54 to 5.21), 3.16 (95% CI = 1.09 to 10.25), and 3.93 (95% CI = 1.46 to 12.27) in the intermediate (n = 293), high (n = 162), and very high (n = 178) risk groups, respectively.

Conclusions: In this study, classifying patients into FENCE risk groups demonstrated moderate discriminatory ability for predicting FN. Further validation in multicenter studies is necessary to determine its generalizability.

Citing Articles

The reliability of FEbrile Neutropenia after ChEmotherapy (FENCE) scores in predicting granulocyte colony-stimulating factor breakthrough febrile neutropenia among patients with lymphoma undergoing first-cycle chemotherapy: A prospective....

Thungthong P, Chamnanchanunt S, Suwanban T, Nakhahes C, Iam-Arunthai K, Akrawikrai T Front Med (Lausanne). 2023; 10:1122282.

PMID: 36993799 PMC: 10040561. DOI: 10.3389/fmed.2023.1122282.


Validation of the FENCE score for prediction of febrile neutropenia during chemotherapy cycles 2-6.

Zatarah R, Faqeer N, Mahmoud A, Quraan T, Matalka L, Kamal A Discov Oncol. 2022; 13(1):107.

PMID: 36251222 PMC: 9576834. DOI: 10.1007/s12672-022-00575-1.

References
1.
Aagaard T, Roen A, Reekie J, Daugaard G, de Nully Brown P, Specht L . Development and Validation of a Risk Score for Febrile Neutropenia After Chemotherapy in Patients With Cancer: The FENCE Score. JNCI Cancer Spectr. 2019; 2(4):pky053. PMC: 6649794. DOI: 10.1093/jncics/pky053. View

2.
Weycker D, Li X, Barron R, Wu H, Morrow P, Xu H . Importance of Risk Factors for Febrile Neutropenia Among Patients Receiving Chemotherapy Regimens Not Classified as High-Risk in Guidelines for Myeloid Growth Factor Use. J Natl Compr Canc Netw. 2015; 13(8):979-86. DOI: 10.6004/jnccn.2015.0118. View

3.
Repetto L . Incidence and clinical impact of chemotherapy induced myelotoxicity in cancer patients: an observational retrospective survey. Crit Rev Oncol Hematol. 2009; 72(2):170-9. DOI: 10.1016/j.critrevonc.2009.03.004. View

4.
Lopez-Pousa A, Rifa J, Casas de Tejerina A, Gonzalez-Larriba J, Iglesias C, Gasquet J . Risk assessment model for first-cycle chemotherapy-induced neutropenia in patients with solid tumours. Eur J Cancer Care (Engl). 2010; 19(5):648-55. PMC: 3082427. DOI: 10.1111/j.1365-2354.2009.01121.x. View

5.
Hirasawa Y, Nakashima J, Sugihara T, Takizawa I, Gondo T, Nakagami Y . Development of a Nomogram for Predicting Severe Neutropenia Associated With Docetaxel-Based Chemotherapy in Patients With Castration-Resistant Prostate Cancer. Clin Genitourin Cancer. 2016; 15(1):176-181. DOI: 10.1016/j.clgc.2016.05.012. View