{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T14:42:48Z","timestamp":1761057768229,"version":"build-2065373602"},"reference-count":20,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2003,6,2]],"date-time":"2003-06-02T00:00:00Z","timestamp":1054512000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2003,7,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Severe neutropenia, a common consequence of chemotherapy, may result in infectious complications and hospitalizations. Preventive treatment with colony\u2010stimulating factors is limited because of the inability to predict which patients will develop neutropenic complications. To the authors' knowledge, the current study is the first large prospective validation of a risk model in patients with early\u2010stage breast carcinoma.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Patients with Stage I\u2013III breast carcinoma who were receiving adjuvant chemotherapy (<jats:italic>n<\/jats:italic> = 624) were assigned to risk groups based on first\u2010cycle absolute neutrophil count (ANC) nadirs of &lt; 0.5 \u00d7 10<jats:sup>9<\/jats:sup>\/L. Filgrastim (a recombinant human granulocyte\u2013colony\u2010stimulating factor) was administered from Cycle 2 onward to high\u2010risk patients. Dose intensity and rates of neutropenic complications, including febrile neutropenia and hospitalization resulting from it, were calculated for each group and compared. High\u2010risk patients were matched by chemotherapy regimen, stage of disease, age, and baseline ANC to historic\u2010control patients and outcomes were compared within the matched pairs.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Both risk groups were found to have a similar proportion of patients receiving &gt; 85% of the dose intensity (95.8% vs. 94.4%). The rate of febrile neutropenia and hospitalization in the low\u2010risk group (<jats:italic>n<\/jats:italic> = 264) was 2.6% (95% confidence interval [95% CI[], 0.7\u20134.5%) and 0.8 (95% CI, \u20100.3\u20131.9%), respectively. The high\u2010risk group was 2.6 times more likely to receive a full dose of chemotherapy, but no higher risk of neutropenic complications was reported compared with the matched controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>The risk\u2010related prophylactic administration of filgrastim facilitated the delivery of planned chemotherapy to the high\u2010risk group of patients. However, further research is needed to confirm the results obtained in the current study in a randomized trial, if feasible, and in other chemotherapy and disease settings. Cancer 2003;98:222\u20138. \u00a9 2003 American Cancer Society.<\/jats:p><jats:p>DOI 10.1002\/cncr.11516<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.11516","type":"journal-article","created":{"date-parts":[[2003,7,14]],"date-time":"2003-07-14T13:08:11Z","timestamp":1058188091000},"page":"222-228","source":"Crossref","is-referenced-by-count":20,"title":["Targeted filgrastim support in patients with early\u2010stage breast carcinoma"],"prefix":"10.1002","volume":"98","author":[{"given":"Edgardo","family":"Rivera","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. Haim","family":"Erder","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy D.","family":"Moore","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas L.","family":"Shiftan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris A.","family":"Knight","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moshe","family":"Fridman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carol","family":"Brannan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurence","family":"Danel\u2010Moore","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel N.","family":"Hortobagyi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"for the Risk Model Study Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2003,7,2]]},"reference":[{"key":"e_1_2_6_2_2","unstructured":"American Cancer Society. Breast cancer facts and figures. Available from URL:www.cancer.org[accessed October 15 2001]."},{"key":"e_1_2_6_3_2","unstructured":"National Alliance of Breast Cancer Organizations. Facts about breast cancer in the U.S. Available from URL:http:\/\/www.nabco.org\/resources\/index.html[accessed November 9 2001]."},{"key":"e_1_2_6_4_2","unstructured":"National Institutes of Health Consensus Development Conference Statement. Adjuvant therapy for breast cancer. City State November 1\u20133 2000. Available from URL:http:\/\/consensus.nih.gov[accessed November 9 2001]."},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199405053301801"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199504063321401"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/90.16.1205"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)03301-7"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(20010915)92:6<1354::AID-CNCR1458>3.0.CO;2-P"},{"key":"e_1_2_6_10_2","first-page":"394a","article-title":"Clinical prediction models for febrile neutropenia (FN) and relative dose intensity (RDI) in patients receiving adjuvant breast cancer chemotherapy","volume":"20","author":"Lyman GH","year":"2001","journal-title":"Proc Am Soc Clin Oncol."},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0959-8049(99)00259-2"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2000.18.20.3558"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199107183250305"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/0959-8049(93)90376-Q"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1159\/000227575"},{"key":"e_1_2_6_16_2","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1177\/107327489600300605","article-title":"Use of G\u2010CSF to sustain dose intensity in breast cancer patients receiving adjuvant chemotherapy: a pilot study","volume":"3","author":"Webster J","year":"1996","journal-title":"Cancer Control"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1998.16.7.2392"},{"key":"e_1_2_6_18_2","first-page":"37a","article-title":"Using first cycle nadir absolute neutrophil count (FCNANC) as a risk factor for neutropenic events: a validation study","volume":"20","author":"Thomas ES","year":"2001","journal-title":"Proc Am Soc Clin Oncol."},{"key":"e_1_2_6_19_2","first-page":"244a","article-title":"Development and validation of a patient\u2010specific predictive instrument for the need for dose\u2010reduction in chemotherapy for breast cancer: a potential decision aid for the use of myeloid growth factors","volume":"20","author":"Savvides P","year":"2001","journal-title":"Proc Am Soc Clin Oncol."},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1998.16.7.2435"},{"key":"e_1_2_6_21_2","first-page":"52","volume-title":"Analysis of binary data","author":"Cox DR","year":"1989"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fcncr.11516","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.11516","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T17:55:01Z","timestamp":1760291701000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.11516"}},"subtitle":["<i>Toward the implementation of a risk model<\/i>"],"short-title":[],"issued":{"date-parts":[[2003,7,2]]},"references-count":20,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2003,7,15]]}},"alternative-id":["10.1002\/cncr.11516"],"URL":"https:\/\/doi.org\/10.1002\/cncr.11516","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"type":"print","value":"0008-543X"},{"type":"electronic","value":"1097-0142"}],"subject":[],"published":{"date-parts":[[2003,7,2]]}}}