Risk Factors for Severe Neutropenia following Intra-Arterial Chemotherapy for Intra-Ocular Retinoblastoma
Risk Factors for Severe Neutropenia following Intra-Arterial Chemotherapy for Intra-Ocular Retinoblastoma
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DOI：
10.1371/journal.pone.0108692
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发表时间：
2014-10-10
期刊：
影响因子：
3.7
通讯作者：
Abramson, David H.
中科院分区：
文献类型：
--
作者：
Dunkel, Ira J.;Shi, Weiji;Abramson, David H.
目的：动脉灌注化疗是治疗眼内视网膜母细胞瘤的有效方法。中性粒细胞减少症是最常见的全身毒性，在这项研究中，我们的目的是确定与严重（>= 3级）neutralization.Methods的发展相关的风险因素：回顾性审查187个可评估周期的美法仑含动脉内化疗的前三个周期管理的106例眼内视网膜母细胞瘤从2006年5月至2011年6月。如果（1）在治疗后7 - 14天间隔内获得血细胞计数结果和（2）未同时给予静脉化疗，则认为周期可评价。结果：54个周期（29%）出现3级（n = 43）或4级（n = 11）中性粒细胞减少。多变量逐步logistic回归显示，在所有3个周期中，较高的美法仑剂量（>0.40 mg/kg）与重度中性粒细胞减少症显著相关（第1周期的比值比为4.11，95%置信区间为1.33-12.73，p = 0.01），但加用拓扑替康和/或卡铂与此无关。在任何analysis.Conclusions：动脉内美法仑为基础的化疗可引起严重的中性粒细胞减少症，特别是当一个剂量大于0.40毫克/公斤的管理与全身化疗的先前治疗是不相关的严重中性粒细胞减少症的风险。可能需要更大样本的进一步研究。
Purpose: Intra-arterial chemotherapy is a promising strategy for intra-ocular retinoblastoma. Neutropenia is the most commonly encountered systemic toxicity and in this study we aimed to determine the risk factors associated with the development of severe (>= grade 3) neutropenia.Methods: Retrospective review of 187 evaluable cycles of melphalan-containing intra-arterial chemotherapy from the first three cycles administered to 106 patients with intra-ocular retinoblastoma from May 2006 to June 2011. Cycles were considered to be evaluable if (1) blood count results were available in the 7 to 14 days post-treatment interval and (2) concurrent intravenous chemotherapy was not administered. Toxicity was assessed via the Common Terminology Criteria for Adverse Events version 4.0.Results: 54 cycles (29%) were associated with grade 3 (n = 43) or grade 4 (n = 11) neutropenia. Multivariate stepwise logistic regression revealed that a higher melphalan dose (>0.40 mg/kg) was significantly associated with severe neutropenia during all 3 cycles (odds ratio during cycle one 4.11, 95% confidence interval 1.33-12.73, p = 0.01), but the addition of topotecan and/or carboplatin were not. Prior treatment with systemic chemotherapy was not associated with severe neutropenia risk in any analysis.Conclusions: Intra-arterial melphalan-based chemotherapy can cause severe neutropenia, especially when a dose of greater than 0.40 mg/kg is administered. Further study with a larger sample may be warranted.