Hematologic Toxicities of Chemotherapy in Lung Cancer Patients: A Retrospective Study in Dr. M. Djamil Hospital Padang, Indonesia

Abstract

The use of chemotherapeutic agents in the management of cancer is often followed by a range of toxicities to various organ systems. A retrospective study on the hematologic toxicities of chemotherapy in lung cancer patients has been carried out. The study was conducted by a cross-sectional method from medical records of four-year data in 2010–2014 at Dr. M. Djamil Hospital Padang, West Sumatra, Indonesia. Data from medical records of patients diagnosed with lung cancer and underwent chemotherapy, not suffering from primary hematologic diseases, and with normal kidney and liver function prior to chemotherapy were studied. A number of 22 medical records of lung cancer patients which met the criteria with a total of 40 chemotherapy cycles were observed. The study revealed that a combination of carboplatin-paclitaxel was the most common chemotherapy used for the patients (72.7%). The hematologic toxicities comprised anemia, leukopenia, and thrombocytopenia with the severity ranging from grade 1–3. Carboplatin-paclitaxel was the only combination that caused these three toxicities, and the only combination to cause thrombocytopenia as well. Anemia was the major hematologic toxicity experienced by more than half of the patients. The study concludes that there is a reasonably high incidence of hematologic toxicities from chemotherapy among lung cancer patients.Keywords: Anemia, chemotherapy, hematologic toxicity, leukopenia, lung cancer, thrombocytopenia Toksisitas Hematologis Akibat Kemoterapi pada Pasien Kanker Paru: Studi Retrospektif di RSUP Dr. M. Djamil PadangAbstrak Penggunaan obat kemoterapi dalam pengobatan kanker sering disertai dengan toksisitas pada beberapa sistem organ. Kajian retrospektif terhadap toksisitas hematologis akibat kemoterapi pada pasien kanker paru sudah dilaksanakan. Studi ini dilaksanakan dengan metode cross-sectional dari data rekam tahun 2010–2014 di RSUP Dr. M. Djamil Padang, Sumatera Barat. Data pasien yang didiagnosis menderita kanker paru yang menjalani kemoterapi, tidak menderita penyakit hematologis dan gangguan hematopoiesis, serta memiliki fungsi ginjal dan hati yang normal dimasukkan ke dalam kajian. Sejumlah 22 pasien memenuhi kriteria dengan jumlah siklus kemoterapi sebanyak 40. Hasil kajian ini mengungkap bahwa kombinasi karboplatin-paklitaksel merupakan kemoterapi yang paling banyak digunakan (72,2%). Toksisitas hematologis yang terjadi meliputi anemia, leukopenia, dan trombositopenia dengan tingkat keparahan 1–3. Karboplatin-paklitaksel merupakan satu-satunya kombinasi kemoterapi yang menyebabkan ketiga toksisitas hematologis tersebut, sekaligus juga merupakan satu-satunya kombinasi yang menimbulkan trombositopenia. Anemia merupakan toksisitas hematologis yang paling banyak terjadi meliputi lebih dari separuh pasien. Penelitian ini menyimpulkan bahwa terdapat toksisitas hematologis yang cukup tinggi akibat kemoterapi pada pasien kanker paru.Kata kunci: Anemia, kanker paru, kemoterapi, leukopenia, toksisitas hematologis, trombositopenia

Profile of Side Effects of Chemotherapy in Non-Small Cell Lung Cancer Patients (NSCLC) Undergoing Chemotherapy at Dr. M. Djamil General Hospital, Padang, Indonesia

“…The higher incidence of adenocarcinoma is often related to the risk factors. 17 Side effects of chemotherapy in this study were found in all regimens given to patients in the form of the CTZ and send impulses to the vomiting center. 24 It is hypothesized that chemotherapy-induced alopecia is the result of direct toxicity to the highly proliferative keratinocyte matrix, as well as the follicular pigmentation system being very sensitive to poisons, and some chemotherapy drugs can cause rapid apoptosis.…”

Hematological Side Effects Management of Paclitaxel - Carboplatin Chemotherapy in Lung Cancer

“…Chemotherapy can only be performed if toxicity does not exceed grade three or hematologic side effects can be corrected, So toxicity levels are decreased. 3 Guastala's 2018 study found the incidence of neutropenia in paclitaxel-carboplatin with WHO Toxicity grade III by 30% and grade IV by 23%. The incidence of thrombocytopenia with WHO Toxicity grade III was 3%, and grade IV was 1%.…”

“…4 Research by Leong in 2004, chemotherapy with a paclitaxel-carboplatin regimen had anemia with whom Toxicity grade III/IV occurred by 41%, thrombocytopenia by 41%, and neutropenia by 78%. 5 Yuliandra et al study found the paclitaxel-carboplatin regimen can cause three toxicity parameters (anemia, leukopenia, and thrombocytopenia), that occurred in grade I -III who toxicity 3 Lee's study in 2011found that leukopenia can occur after the first cycle of paclitaxel-carboplatin chemotherapy. 6 The incidence of hematologic toxicity (anemia and neutropenia) In Asians was higher than non-Asians.…”