Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/20564
Title: Clinical correlates of severe thrombocytopenia from temozolomide in glioblastoma patients.
Austin Authors: Arulananda, Surein;Lynam, James;Sem Liew, Mun;Wada, Morikatsu ;Cher, Lawrence;Gan, Hui K 
Affiliation: Victorian Oncology Care, The University of Melbourne, Melbourne, Victoria, Australia
Department of Medical Oncology, Calvary Mater Newcastle, Newcastle, New South Wales, Australia
Department of Medical Oncology, Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Heidelberg, Victoria, Australia
Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia
School of Cancer Medicine, Latrobe University, Melbourne, Victoria, Australia
Faculty of Medicine, Dentistry and Health Science, The University of Melbourne, Melbourne, Victoria, Australia
Department of Radiation Oncology, Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Heidelberg, Victoria, Australia
Issue Date: Oct-2018
Publication information: Internal Medicine Journal 2018; 48(10): 1206-1214
Abstract: 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. 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). 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. 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.
URI: http://ahro.austin.org.au/austinjspui/handle/1/20564
DOI: 10.1111/imj.14000
ORCID: 0000-0002-5636-6381
PubMed URL: 29923272
Type: Journal Article
Subjects: glioblastoma
myelosuppression
radiotherapy
temozolomide
thrombocytopenia
Appears in Collections:Journal articles

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