A Study on the Leukopenia during Chemotherapy in Patients with Gynecologic Malignancies.
- Author:
Sam Hyun CHO
;
Kyung Tae KIM
;
Hyung MOON
;
Yoon Young HWANG
;
Young Jin MOON
;
Jong Woon BAE
- Publication Type:Original Article
- MeSH:
Anti-Bacterial Agents;
Bone Marrow;
Drug Therapy*;
Fever;
Granulocyte Colony-Stimulating Factor;
Granulocyte-Macrophage Colony-Stimulating Factor;
Granulocytes;
Gynecology;
Hemorrhage;
Humans;
Leukopenia*;
Mortality;
Obstetrics;
Sepsis
- From:Korean Journal of Gynecologic Oncology and Colposcopy
2000;11(2):131-139
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
The recent introduction of chemotherapy in the treatment of the gynecologic malignancies has gained wide acceptance along with preoperative and postoperative adjuvant therapy and with preradiation and concurrent chemoradiaton therapy. But, the side effects of chemotherapy including bleeding and infection due to bone marrow suppression have resulted in increased morbidity and mortality of the patients and delayed treatment and a reduction in the chemotherapeutic agents used. In spite of the development of antibiotics and the supportive care of infection, sustained leukopenia in the patients during chemotherapy accounts for the high mortality rate due to sepsis. The early detection of the leukopenia during chemotherapy may enable clinicians to overcome infection problems by timely use of prophylactic broad spectrum antibiotics and G-CSF or GM-CSF. The author investigated the grade, duration, time of onset and other clinical features of the leukopenia and the effects of the age (> or =60 years vs <60 years), the number of the cycle of chemotherapy (> or =3 cycles vs < 3 cycles), fever and performance scale on the leukopenia. 79 cases (32 patients) of the leukopenia during chemotherapy of various gynecologic malignancies at the Department of Obstetrics and Gynecology at Hanyang University between January, 1996 and December, 1998 entered to this study. The results were as follows; 1. Leukopenia occurred at 14.2+/-6.1 day from the first day of chemotherapy, 2. The duration of leukopenia was 2.5+/-1.6 days 3. No significant difference was found between eldely patients ( > or =60 years, n=13) and younger patients ( <60 years, n=66) about the severity, duration and time of onset of leukopenia. 4. No significant difference was found between the patients with more than 3 cycles of chemotherapy (n=40) and less than 3 cycles (n=39) about the severity, duration and time of onset of leukopenia. 5. Febrile leukopenic cases (n=6) had significantly lower granulocyte count, longer leukopenic period and earlier onset of leukopenia than afebrile (n=73). 6. It is thought that performance status scale does not affect the grade of leukopenia, onset of leukopenia and the leukopenic period.
