Grade 4 Neutropenia Frequency as a Binary Risk Predictor for Adverse Clinical Consequences of Chemotherapy‑Induced Neutropenia: A Meta-analysis

Neutropenia is the major toxicity of myelosuppressive cancer chemotherapy. Grade 4 neutropenia (Gr4N) is a measure of chemotherapy-induced neutropenia (CIN) severity. We conducted a meta-analysis of CIN data. Gr4N incidence was significantly correlated with febrile neutropenia (FN), days of severe neutropenia (DSN), and nadir absolute neutrophil count (ANC), which are all important predictors of morbidity. With a Gr4N threshold of 65%, both FN and DSN were below levels for low risk of adverse CIN outcomes. Gr4N was highly predictive for adverse CIN outcomes, and a 65% threshold demarcated low vs. high risk for FN and other adverse CIN outcomes.中性粒细胞减少症（Neutropenia）是骨髓抑制性癌症化疗的主要毒性反应。4级中性粒细胞减少症（Grade 4 neutropenia, Gr4N）是化疗诱导性中性粒细胞减少症（chemotherapy-induced neutropenia, CIN）严重程度的衡量指标。本研究针对CIN数据开展了一项荟萃分析。结果显示，Gr4N的发生率与发热性中性粒细胞减少症（febrile neutropenia, FN）、重度中性粒细胞减少持续天数（days of severe neutropenia, DSN）以及中性粒细胞绝对计数谷值（nadir absolute neutrophil count, ANC）均呈显著相关，上述指标均为不良临床结局的重要预测因子。当Gr4N阈值设定为65%时，FN与DSN均处于不良CIN结局的低风险水平。Gr4N对不良CIN结局具有较高的预测价值，且65%的阈值可有效界定FN及其他不良CIN结局的高、低风险人群。