Risk Factors for Developing Neutropenia

Multiple risk factors exist for the development of neutropenia. Greatly influencing the possible development of neutropenia is the type of chemotherapy and/or radiation, the doses, and the administration schedule of the treatment regimen. Additionally, dose density (administration of chemotherapy more frequently that was once standard- such as every 2 weeks instead of every 3 weeks), dose intensity (giving the maximum tolerable dose at each administration), and relative dose intensity (a percentage of the dose intensity that is given as a portion of the dose that is planned) also greatly impact the potential for neutropenia development (Nirenberg, 2006).

Risk Factors also include:

• Pre-existing neutropenia from previous cycles of treatment
• Pre-existing neutropenia as a consequence of disease
• Use of highly myelosuppressive agents
• Tumor in the bone marrow
• Poor immune functioning
• History of neutropenia with current or previous therapies
• Malnutrition
• Hepatic or renal dysfunction
• Chemoradiation
• Concurrent use of two or more of the following: antibiotics, antifungals, allopurinol, corticosteroids, or sulfa drugs (Polovich, et al, 2005)
• Comorbidities (such as COPD, cardiovascular disease, liver or renal insufficiency, diabetes mellitus, anemia)
• Patient factors (such as age > 65, female gender, poor performance status, decreased body surface area)
• Open wounds or active infection, including mucositis (Eaton & Tipton, 2009)