Search for risks of intravenous chemotherapy-induced severe neutropenia in solid cancers

Chemotherapy-induced neutropenia is a common adverse effect, with severe neutropenia associated with significant morbidity, mortality, and costs that require immediate evaluation and treatment. To identify the risk factors that may predispose adult patients with solid cancers to severe intravenous chemotherapy-induced neutropenia, we conducted a retrospective study. A study was performed by collecting data of solid cancer patients who received intravenous chemotherapy from January 2023 to May 2024 at Shanghai Sixth People’s Hospital Affiliated to Shanghai JiaoTong University, South Campus. Patient data including age, sex, body mass index, Eastern Cooperative Oncology Group (ECOG) performance status, number of chemotherapy lines, number of chemotherapy drugs, radiotherapy history, and comorbidities were collected. We analyzed potential risk factors for severe neutropenia. In total, 343 patients were included in the analysis. Multivariate analysis showed that female sex (odds ratio [OR] 1.84; 95% confidence interval [CI] 1.06–3.18; P < .03), number of chemotherapy lines (OR 1.51; 95% CI 1.06–2.13; P < .02), and radiotherapy history (OR 2.53; 95% CI 1.04–6.19; P < .04) were independent predictors of severe neutropenia. Comorbidity (OR, 0.46; 95% CI 0.26–0.81; P < .007) was found to be an independent predictor of no severe neutropenia. In conclusion, we found that female sex, a larger number of chemotherapy lines, and a history of radiotherapy might be predictors of severe neutropenia. Comorbidity may be a protective factor against severe neutropenia.