• J. Clin. Oncol. · Nov 2003

    Risk model predictive of severe anemia requiring RBC transfusion after chemotherapy in pediatric solid tumor patients.

    • Perrine Marec-Berard, Jean Yves Blay, Matthias Schell, Murielle Buclon, Corrine Demaret, and Isabelle Ray-Coquard.
    • Pediatric Oncology Unit, INSERM U590, the Statistics department, and Centre Léon Bérard, Lyon Cedex, France. marec@lyon.fnclcc.fr
    • J. Clin. Oncol. 2003 Nov 15;21(22):4235-8.

    PurposeSevere anemias requiring RBC transfusions is a frequent complication of chemotherapy. A model elaborated by Ray-Coquard et al in adults pointed to three independent risk factors for RBC transfusion: performance status (PS) more than 1, hemoglobin less than 12 g/dL, and prechemotherapy absolute lymphocyte count (ALC) < or = 700/microL. This model is tested on a pediatric population.Patients And MethodsOne hundred nineteen children with solid tumors consecutively admitted for conventional chemotherapy throughout 1 year were included. The study end point was the RBC-transfusion risk in the month following chemotherapy. Only one course was considered for each patient. Age, sex, number of courses, platinum-containing regimens, PS, and hemoglobin and lymphocyte count at day 1 were tested in univariate and multivariate analyses.ResultsThirty-one (26%) of 119 children required RBC transfusion within 31 days of chemotherapy. Three factors correlated to transfusion risk in the univariate analysis: PS more than 1 (P <.001), hemoglobin less than 12 g/dL (P =.007), and pretreatment ALC < or = 700/microL (P <.001). In the multivariate analysis, hemoglobin less than 12 g/dL, PS more than 1, and ALC < or = 700/microL were identified as independent factors predicting RBC transfusion. The calculated probability of receiving RBC transfusion within 31 days of chemotherapy was high with three risk factors (96%), intermediate with two risk factors (53% to 77%), low with one risk factor (10% to 26%), and very low when no risk factor was present (2%). The difference of transfusion needs was significant (P <.001).ConclusionThe risk model elaborated for adults may also segregate children at high risk of postchemotherapy RBC transfusion, thus facilitating assessment of risk of transfusion and/or prophylactic erythropoietin support.

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