Complications of cytotoxic chemotherapy in older patients: focus on myelotoxicity in lymphomas

Zinzani, Pier Luigi

doi:10.1016/j.critrevonc.2003.04.002

Cited by 6 publications

(2 citation statements)

References 42 publications

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“…This multicenter, prospective, observational study for a population of 1,285 Chinese gastric cancer patients treated with six selected cytotoxic conventional regimens in community settings revealed a high prevalence of anaemia at baseline and increasing trend of myelotoxicity incidence over successive cycles. The prevalence, incidence and frequency of myelotoxicity among our study population were much higher than those of other relevant studies in western countries 11 , 12 . This is probably due to patient and regimen selection bias, the population we studied were those with gastric cancer executively received platinum-based polychemotherapy, which are known to cause myelotoxicity 13 , 14 .…”

Section: Discussioncontrasting

confidence: 74%

Profiling chemotherapy-associated myelotoxicity among Chinese gastric cancer population receiving cytotoxic conventional regimens: epidemiological features, timing, predictors and clinical impacts

Zhu

Wang

et al. 2017

J. Cancer

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Objectives: We aim to evaluate the epidemiological features, timing, predictors and clinical impacts of chemotherapy-associated myelotoxicity in Chinese gastric cancer population receiving six established cytotoxic conventional regimens (CF/XP, EC(O)F/EC(O)X, DC(O)F/DC(O)X, PC(O)F/PC(O)X, FOLFOX4, or mFOLFOX7/XELOX).Patients and methods: A 4-year multicenter, prospective, observational study was conducted in multiple hospitals/institutes spanning three major regions in China. A total of 1,285 patients with gastric cancer, treated with six selected regimens between 2010 and 2014 were included. Kaplan-meier analysis was applied to estimate the time to develop myelotoxicity events for each regimen. Multivariable logistic regression model was built to identify predictors associated with chemotherapy-induced myelotoxicity, evaluating detailed specific factors of patients, disease and treatment patterns.Results: Triplet regimens were associated with more moderate-to-severe myelotoxicity events than doublet regimens. DC(O)F/DC(O)X group presented with moderate-to-severe anaemia, thrombocytopenia, and leukopenia earlier than other regimen groups, with median time of 3.5, 4.8 and 3.3 cycles, respectively. PC(O)F/PC(O)X group had a shortest time to develop Moderate-to-Severe neutropenia (median time, 3.3 cycles). Multivariate analysis identified several independent predictors for moderate-to-severe myelotoxicity, including: baseline Hb<12.0 g/dL, male gender, KPS<80, previously treated with surgery, tumor located at gastroesophageal junction(GEJ), DC(O)F/DC(O)X regimen, palliative intent, triplet combination therapy and No. of cycles received≥4. Dose reductions≥20% occurred in 16.7% of patients and treatment delays≥7 days presented in 21.1% of patients, resulting in patients receiving an actual average Relative Dose Intensity (RDI) of 0.733.Conclusions: Myelotoxicity events were frequently observed within the gastric cancer population undertaking multicycle polychemotherapy. Predictive models based on risk factors identified for moderate-to-severe myelotoxicity should enable the targeted use of appropriate supportive care in an effort to facilitate the delivery of full chemotherapy doses on schedule.

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Section: Discussioncontrasting

confidence: 74%

Profiling chemotherapy-associated myelotoxicity among Chinese gastric cancer population receiving cytotoxic conventional regimens: epidemiological features, timing, predictors and clinical impacts

Zhu

Wang

et al. 2017

J. Cancer

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“…However, chemotherapy leads to many complications in the patient because of its toxic side effects (5,6). Chemotherapy agents affect not only the growth of tumor cells but also the proliferation of normal cells such as bone marrow (7) and oral mucosal cells (8). When severe complications are observed, dose reduction or alternative agents should be considered (5).…”

Section: Introductionmentioning

confidence: 99%

4-hexylresorcinol inhibits NF-κB phosphorylation and has a synergistic effect with cisplatin in KB cells

et al. 2011

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Cisplatin is a representative anti-cancer drug and 4-hexylresorcinol (4-HR) is known as an antiparasitic and antiseptic agent. The aims of this study were to evaluate the effect of 4-HR on the activation of nuclear factor-κB (NF-κB) in cell cultures, to evaluate the antitumor effect of 4-HR plus cisplatin combination therapy in a xenograft model, and to evaluate transglutaminase-2 (TG-2) and phosphorylated NF-κB (pNF-κB) expression in the xenograft model. To determine the effect of 4-HR on NF-κB phosphorylation, co-immunoprecipitation and Western blot analysis were done in KB cells. To examine the in vivo effect of the cisplatin plus 4-HR combination therapy, KB cells were grafted into nude mice. Drugs were injected into the peritoneal cavity daily. Tumor size, body weight, and duration of survival were checked daily. Specimens from main mass were used in immunohistochemical staining for the analysis of TG-2 and pNF-κB expression. In the in vitro test, as the 4-HR concentrations increased, the fraction of the bound complex NF-κB-inhibitory-κB (IκB) increased. Consequently, the level of free IκB decreased. In the xenograft model, the cisplatin plus 4-HR group exhibited a significantly decreased tumor growth rate than in the saline group (P=0.039). The mean survival time of the cisplatin plus 4-HR group was 51.20±3.96 days and was significantly prolonged compared with the other groups (P<0.05). The body weight of the cisplatin plus 4-HR group had significantly less weight loss than the cisplatin only group (P=0.045). In the immunohistochemical analysis, the cisplatin plus 4-HR group had a significantly lower expression of TG-2 and pNF-κB compared to the saline group (P<0.05). In conclusion, cisplatin plus 4-HR combination therapy had clear advantages over the cisplatin only treatment such as similar tumor growth inhibition compared to the cisplatin only treatment despite the reduced dosage of cisplatin, less body weight loss, and prolonged survival time.

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Current awareness: Pharmacoepidemiology and drug safety

2004

Pharmacoepidemiology and Drug

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of pharmacoepidemiology and drug safety. Each bibliography is divided into 19 sections: 1 Books, Reviews & Symposia; 2 General; 3 Anti‐infective Agents; 4 Cardiovascular System Agents; 5 CNS Depressive Agents; 6 Non‐steroidal Anti‐inflammatory Agents; 7 CNS Agents; 8 Anti‐neoplastic Agents; 9 Haematological Agents; 10 Neuroregulator‐Blocking Agents; 11 Dermatological Agents; 12 Immunosuppressive Agents; 13 Autonomic Agents; 14 Respiratory System Agents; 15 Neuromuscular Agents; 16 Reproductive System Agents; 17 Gastrointestinal System Agents; 18 Anti‐inflammatory Agents ‐ Steroidal; 19 Others. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted.

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Complications of cytotoxic chemotherapy in older patients: focus on myelotoxicity in lymphomas

Cited by 6 publications

References 42 publications

Profiling chemotherapy-associated myelotoxicity among Chinese gastric cancer population receiving cytotoxic conventional regimens: epidemiological features, timing, predictors and clinical impacts

Profiling chemotherapy-associated myelotoxicity among Chinese gastric cancer population receiving cytotoxic conventional regimens: epidemiological features, timing, predictors and clinical impacts

4-hexylresorcinol inhibits NF-κB phosphorylation and has a synergistic effect with cisplatin in KB cells

Current awareness: Pharmacoepidemiology and drug safety

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