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Albumin‐bilirubin score for predicting neuropsychiatric symptoms in patients receiving ifosfamide‐based chemotherapy
Author(s) -
Shimizu Shinya,
Hayashi Yuichi,
Nishida Shohei,
Fujii Hironori,
Nakamura Mitsuhiro,
Yoshikura Nobuaki,
Nagano Akihito,
Kitagawa Junichi,
Kanemura Nobuhiro,
Mizutani Kosuke,
Kobayashi Ryo,
Ishihara Takuma,
Hayashi Hideki,
Shimohata Takayoshi,
Sugiyama Tadashi,
Suzuki Akio
Publication year - 2021
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/jcpt.13355
Subject(s) - ifosfamide , medicine , hazard ratio , chemotherapy , proportional hazards model , delirium , incidence (geometry) , bilirubin , gastroenterology , oncology , surgery , confidence interval , psychiatry , physics , etoposide , optics
What is known and objective Ifosfamide, an alkylating agent, is widely used in the treatment of malignant diseases. However, these treatments are often limited due to the incidence of neuropsychiatric symptoms such as delirium, seizures, hallucinations and agitation. In this study, we examined risk factors for neuropsychiatric symptoms in patients receiving ifosfamide‐based chemotherapy. Methods The study cases were patients with cancer receiving ifosfamide‐based chemotherapy between April 2007 and March 2018. Risk analysis for ifosfamide‐related neuropsychiatric symptoms was determined by time‐dependent Cox proportional hazard regression analysis. Results and discussion Of 183 eligible patients, 32 patients (17.5%) experienced ifosfamide‐related neuropsychiatric symptoms. Time‐dependent Cox proportional hazard model showed that the albumin‐bilirubin (ALBI) score was significantly correlated with the incidence of ifosfamide‐related neuropsychiatric symptoms (hazard ratio [HR] =1.45, 95% confidence interval [CI] = 1.05–2.01, p = 0.025). Additionally, there were correlations between the predicted risk of neuropsychiatric symptoms and ifosfamide‐dose per cycle (HR =0.51, 95% CI = 0.27–0.94, p = 0.030) and creatinine clearance (Ccr) (HR = 0.53, 95% CI = 0.28–1.00, p = 0.050). In contrast, neither serum albumin nor total bilirubin was a significant risk factor for neuropsychiatric symptoms. What is new and conclusion These findings indicate that ALBI score may be a useful biomarker for predicting neuropsychiatric symptoms in patients receiving ifosfamide‐based chemotherapy.