Predicting Risk of Severe Neutropenia With a Nomogram

A nomogram could help to predict patients at risk of Grade 4 neutropenia during treatment, according to a study published in Clinical Genitourinary Cancer.

Nomograms are used in oncology as prediction tools to help patients and physicians make treatment decisions. The device uses an alpha-numeric code to describe something unique about the patient: genetic makeup, tumor makeup, comorbidities, social environment, etc.

Researchers from Tokyo Medical University in Japan studied 112 patients with castration-resistant prostate cancer (CRPC) who were treated with docetaxel-based systemic chemotherapy. Neutropenia is a major adverse event of docetaxel-based chemotherapy and the researchers sought to develop a nomogram for predicting Grade 4 neutropenia during the first cycle of chemotherapy.

More than half (55.4%) of the patients developed Grade 4 neutropenia in the first cycle of docetaxel-based chemotherapy. The researchers noted that there were significant differences in age, baseline white blood cell count, and baseline neutrophil count among patients with non-Grade 4 neutropenia and those with Grade 4 neutropenia.

However, there were not significant differences between the 2 groups when it came to serum prostate-specific antigen level, hemoglobin level, creatinine, albumin, Eastern Cooperative Oncology Group performance status, metastatic sites, extent of disease, and history of external beam radiotherapy to the prostate.

As a result, the researchers determined that age and baseline neutrophil counts were significant independent risk factors for severe neutropenia.

“Age and baseline neutrophil counts were significant independent risk factors for Grade 4 neutropenia,” the authors concluded. “The nomogram to predict it provides useful information for the management of patients with CRPC treated with docetaxel chemotherapy.”