PURPOSE: We performed a systematic review and meta-analysis to determine the impact of neutropenia or leukopenia experienced during chemotherapy on survival. METHODS: Eligible studies included prospective or retrospective analyses that evaluated neutropenia or leukopenia as a prognostic factor for overall survival or disease-free survival. Statistical analyses were conducted to calculate a summary hazard ratio and 95% confidence interval (CI) using random-effects or fixed-effects models based on the heterogeneity of the included studies. RESULTS: Thirteen trials were selected for the meta-analysis, with a total of 9,528 patients. The hazard ratio of death was 0.69 (95% CI, 0.64-0.75) for patients with higher-grade neutropenia or leukopenia compared to patients with lower-grade or lack of cytopenia. Our analysis was also stratified by statistical method (any statistical method to decrease lead-time bias; time-varying analysis or landmark analysis), but no differences were observed. CONCLUSIONS: Our results indicate that neutropenia or leukopenia experienced during chemotherapy is associated with improved survival in patients with advanced cancer or hematological malignancies undergoing chemotherapy. Future prospective analyses designed to investigate the potential impact of chemotherapy dose adjustment coupled with monitoring of neutropenia or leukopenia on survival are warranted.
PURPOSE: We performed a systematic review and meta-analysis to determine the impact of neutropenia or leukopenia experienced during chemotherapy on survival. METHODS: Eligible studies included prospective or retrospective analyses that evaluated neutropenia or leukopenia as a prognostic factor for overall survival or disease-free survival. Statistical analyses were conducted to calculate a summary hazard ratio and 95% confidence interval (CI) using random-effects or fixed-effects models based on the heterogeneity of the included studies. RESULTS: Thirteen trials were selected for the meta-analysis, with a total of 9,528 patients. The hazard ratio of death was 0.69 (95% CI, 0.64-0.75) for patients with higher-grade neutropenia or leukopenia compared to patients with lower-grade or lack of cytopenia. Our analysis was also stratified by statistical method (any statistical method to decrease lead-time bias; time-varying analysis or landmark analysis), but no differences were observed. CONCLUSIONS: Our results indicate that neutropenia or leukopenia experienced during chemotherapy is associated with improved survival in patients with advanced cancer or hematological malignancies undergoing chemotherapy. Future prospective analyses designed to investigate the potential impact of chemotherapy dose adjustment coupled with monitoring of neutropenia or leukopenia on survival are warranted.
Authors: Arun Ganti; Weijian Liu; Suhong Luo; Kristen M Sanfilippo; Ryan Roop; Ryan Lynch; Peter Riedell; Katiuscia O'Brian; Graham A Colditz; Kenneth R Carson Journal: Br J Haematol Date: 2014-07-15 Impact factor: 6.998
Authors: Juwon Park; Robert W Wysocki; Zohreh Amoozgar; Laura Maiorino; Miriam R Fein; Julie Jorns; Anne F Schott; Yumi Kinugasa-Katayama; Youngseok Lee; Nam Hee Won; Elizabeth S Nakasone; Stephen A Hearn; Victoria Küttner; Jing Qiu; Ana S Almeida; Naiara Perurena; Kai Kessenbrock; Michael S Goldberg; Mikala Egeblad Journal: Sci Transl Med Date: 2016-10-19 Impact factor: 17.956
Authors: Alexander T Sougiannis; Brandon N VanderVeen; J Mark Davis; Daping Fan; E Angela Murphy Journal: Am J Physiol Gastrointest Liver Physiol Date: 2021-01-20 Impact factor: 4.052