ALBANY, NYA team of leading oncologists and hematologists has
begun a study designed to help physicians more accurately predict and
manage neutropenia. The Awareness of Neutropenia in Chemotherapy
(ANC) Study Group was formed to develop more accurate prediction
models for neutropenia.
We have the tools to prevent neutropenia, but right now
its very difficult to predict which of our patients will
develop this potentially serious condition, Gary Lyman, MD,
MPH, Albany Medical Center, and a study leader, said in a news
release announcing the formation of the study group. Its
not practical to cover our bases by treating everyone preventively,
so most oncologists cross their fingers, hope for the best, and treat
patients if needed. This is not ideal, for many reasons.
Members of the study group point to numerous drawbacks associated
with the absence of a neutropenia prediction model:
Regardless of whether it progresses, neutropenia often results
in chemotherapy delays or dose reductions that compromise the
long-term effectiveness of chemotherapy.
The increasing complexity and intensity of chemotherapy
regimens means that physicians and patients want to minimize the
number of medications a patient must take. Rather than treat
conditions prophylactically, many physicians and patients will opt to
watch and wait.
In one study, patients who experienced a first
neutropenia-related dose modification had a 55% chance of having a
Stated most simply, the objectives of our study are to help
oncologists better understand which cancer patients may be at
increased risk for developing neutropenia, and, therefore, which will
benefit from proactive management strategies, said David Dale,
MD, professor of medicine, University of Washington Medical Center.
Unfortunately, most cancer clinical studies of the past decade
have reported only the simplest measures of neutropenia over the
short term, so the data we need to make these decisions simply
dont exist right now.
The ANC study is being directed by three leading US hematologists and
oncologists: Dr. Lyman, Dr. Dale, and Jeffrey Crawford, MD, of Duke
University Medical Center.
The remainder of the study group will comprise oncologists from
around the world, coordinated by a staff of eight researchers at the
Albany Medical Center Cancer Center under the direction of Dr. Lyman.
The initiative is funded by a research grant from Amgen.
Members of the study group will utilize the strict rules of
meta-analysis to collect, analyze, and pool appropriate data from
previous chemotherapy trials, including data from the existing
medical literature, unpublished studies, and government reports.
Members will contact original investigators as necessary to gain
access to previously unreported data, particularly any data relevant
The group also plans to initiate several new trials focused on
special issues related to neutropenia, including the impact of this
condition on quality of life, the economic impact of neutropenia, the
role of neutropenia in infection-related mortality, the impact of
neutropenia-related dose reduction on long-term survival, and the
special problems of the elderly in dealing with chemotherapy-induced