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Clinical correlates of severe thrombocytopenia from temozolomide in glioblastoma patients
Author(s) -
Arulananda Surein,
Lynam James,
Sem Liew Mun,
Wada Morikatsu,
Cher Lawrence,
Gan Hui K.
Publication year - 2018
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/imj.14000
Subject(s) - medicine , temozolomide , discontinuation , radiation therapy , chemotherapy , retrospective cohort study , surgery , adjuvant
Background/Aim This study was conducted retrospectively to evaluate rates of thrombocytopenia and their clinical impact during chemo‐radiotherapy for glioblastomas and to elucidate associated clinical factors. Methods A total of 64 patients who received temozolomide chemotherapy at our institution was included; 35 patients received full‐dose chemo‐radiotherapy as per the STUPP protocol (Group A), and 9 patients received abbreviated radiotherapy with concurrent chemotherapy (Group B). Twenty patients received temozolomide alone with an intended 12 cycles of therapy for first relapse at least 6 months after completion of adjuvant chemotherapy (Group C). Results In Group A, 27 of 35 (77%) patients completed the chemo‐radiotherapy phase; 14% had grade 3–4 thrombocytopenia leading to discontinuation. Of 27 patients, 16 (59%) completed adjuvant chemotherapy. There were no grade 3–4 thrombocytopenias, but 4% discontinued due to grade 2 thrombocytopenias. In Group B, four of nine (45%) patients completed the chemo‐radiotherapy phase; 11% had grade 3–4 thrombocytopenias and discontinued treatment. Three of four (75%) patients completed adjuvant chemotherapy. Of these, 75% had grade 3–4 thrombocytopenias, but none discontinued. Finally, in Group C, 8 of 20 (40%) patients completed, with 10% discontinuing due to thrombocytopenias and the rest due to disease progression. In exploratory analyses, being female increased the risk of myelosuppresion, and there was a trend noticed in patients having a higher body surface area. Conclusion Our toxicity data were within range of the literature. We identified the group of patients that have increased thrombocytopenia risk. Larger pooled retrospective series and prospective studies are required.