Cancer Chemotherapy and Pharmacology

, Volume 68, Issue 2, pp 301–307 | Cite as

Meta-analysis of neutropenia or leukopenia as a prognostic factor in patients with malignant disease undergoing chemotherapy

  • Kohei Shitara
  • Keitaro Matsuo
  • Isao Oze
  • Ayako Mizota
  • Chihiro Kondo
  • Motoo Nomura
  • Tomoya Yokota
  • Daisuke Takahari
  • Takashi Ura
  • Kei Muro
Original Article

Abstract

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.

Keywords

Chemotherapy Neutropenia Leukopenia Prognostic factor Meta-analysis 

Notes

Conflict of interest

None of the authors have financial or personal conflicts of interest to disclose.

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Kohei Shitara
    • 1
  • Keitaro Matsuo
    • 2
  • Isao Oze
    • 2
  • Ayako Mizota
    • 1
  • Chihiro Kondo
    • 1
  • Motoo Nomura
    • 1
  • Tomoya Yokota
    • 1
  • Daisuke Takahari
    • 1
  • Takashi Ura
    • 1
  • Kei Muro
    • 1
  1. 1.Department of Clinical OncologyAichi Cancer Center HospitalChikusa-ku, NagoyaJapan
  2. 2.Division of Epidemiology and PreventionAichi Cancer Center Research InstituteChikusa-ku, NagoyaJapan

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