Analysis on risk factors of myelosuppression caused by nedaplatin in patients with lung cancer
10.3760/cma.j.cn114015-20190327-00292
- VernacularTitle:奈达铂致肺癌患者骨髓抑制的危险因素研究
- Author:
Xiaoli LI
1
;
Kunrong WU
;
Ying YIN
;
Rui LI
;
Shufang ZHANG
;
Ziwan GUAN
;
Yan LI
Author Information
1. 山东第一医科大学（山东省医学科学院）药学院，山东省泰安市 271000
- Publication Type:Journal Article
- Keywords:
Antineoplastic combined chemotherapy protocols;
Platinum compounds;
Risk factors;
Regression analysis;
Myelosuppression
- From:
Adverse Drug Reactions Journal
2020;22(4):239-246
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the risk factors of myelosuppression caused by nedaplatin in patients with lung cancer.Methods:The medical records of postoperative patients with advanced lung cancer and receiving nedaplatin-based chemotherapy in Shandong Provincial Qianfoshan Hospital from June 2015 to August 2018 were searched using hospital information system and analyzed retrospectively. According to sex, age (<60 years old, ≥ 60 years old), glutathione mercaptotransferase (GSTP) 1A313G genotype (AA or AG), pathological classification (non-small cell lung cancer, small cell lung cancer), having smoking history or not, being with or without liver injury and kidney injury, the patients were divided into 2 groups, respectively. The overall myelosuppression incidence and incidences of myelosuppression with different manifestations and different degrees were compared respectively between each 2 groups of patients with above-mentioned 7 different clinical features. The risk factors of nedaplatin-induced myelosuppression were analyzed using logistic regression.Results:A total of 46 patients were enrolled, including 34 males and 12 females. Among the 46 patients, 30 cases developed myelosuppression after administration of nedaplatin, and the overall incidence of myelosuppression was 65.2%, including 20 cases of grade Ⅰ-Ⅱ (43.5%) and 10 cases of grade Ⅲ-Ⅳ (21.7%). After administration of nedaplatin, the incidence of severe myelosuppression in patients with small cell lung cancer (3/5) was higher than that with non-small cell lung cancer (17.1%) ( P<0.05), showed by the univariate analysis; the overall incidence of leukopenia in males was higher than that in females (58.8% vs. 25.0%); the overall incidence of leukopenia and neutropenia was higher in patients with smoking history than that in patients without previous smoking history (68.0% vs. 28.6%, 0.01%, P=0.01; 64.0% vs. 33.3%, P=0.04); the overall incidence of thrombocytopenia in patients with small cell lung cancer was higher than that with non-small cell lung cancer (4/5 vs. 9.8%, P<0.01); the differences in the incidences of different degrees of neutropenia in patients with and without smoking history were statistically significant ( P=0.03); the differences in the incidences of different degrees of leukopenia, neutropenia, and thrombocytopenia in patients with different pathological classification were statistically significant ( P<0.01 for all). The binary logistic regression analysis showed that the risk of thrombocytopenia in patients with small cell lung cancer was higher than that with non-small cell lung cancer ( OR=25.00, 95 %CI:2.20-284.61, P=0.01). The orderial logistic regression analysis showed that a pathological classification of small cell lung cancer was a risk factor for severe myelosuppression, leukopenia, neutropenia, and thrombocytopenia ( OR=13.20, 95 %CI: -4.67-0.49, P=0.02; OR=22.20, 95 %CI: -5.37-0.83, P=0.01; OR=19.49, 95 %CI: -5.11-0.82, P=0.01; OR=13.87, 95 %CI: -4.89-0.38, P=0.02). Conclusions:A pathological classification of small cell lung cancer is an independent risk factor for severe myelosuppression in lung cancer patients after taking nedaplatin. Male patients with a history of smoking are more likely to have leukopenia/neutropenia.
