Table 1. Factors to Consider in Assessing Risk of a Febrile
Neutropenic Episode in Patients Undergoing
Cytotoxic Chemotherapy for Malignancy
Factors
Related to: Factor Effect on Risk
Treatment for
malignancy
Cytotoxic
regimen
Risk is higher with regimens that administer:
• anthracyclines at doses ≥90 mg/m
2
• cisplatin at doses ≥100 mg/m
2
• ifosfamide at doses ≥9 grams/m
2
• cyclophosphamide at doses ≥1 gram/m
2
• etoposide at doses ≥500 mg/m
2
• cytarabine at doses ≥1 gram/m
2
• high dose-density
• anthracycline + taxane, & cyclophosphamide or
gemcitabine, for breast cancer
Dose intensity Increased risk if >85% of scheduled doses are
administered
Degree &
duration of
GI &/or oral
mucositis
Risk is greatest if NCI mucositis grade is ≥3 (GI) or if
peak score on OMAS is ≥2
Degree &
duration of
cytopenias
Profound, protracted neutropenia:
• ANC <100/µL for ≥7 days
• lymphopenia: ALC <700/µL (ANC surrogate)
• monocytopenia: AMC <150/µL (ANC surrogate)
(cont'd)
