乙型肝炎或丙型肝炎病毒感染患者的乳腺癌化疗的血液学安全性。

Hematologic safety of breast cancer chemotherapies in patients with hepatitis B or C virus infection.

机构信息

Department of Breast Oncology and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.

出版信息

Oncology. 2012;82(4):228-33. doi: 10.1159/000336904. Epub 2012 Apr 12.

DOI:10.1159/000336904

PMID:22508294

Abstract

BACKGROUND

Information regarding hematological toxicities in breast cancer chemotherapy patients with hepatitis B (HBV) or C virus (HCV) infection is limited.

METHODS

We retrospectively reviewed the presence of hepatotoxicities (i.e. aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and bilirubin elevation) and hematotoxicities (i.e. leukopenia and thrombocytopenia) among breast cancer patients with HBV or HCV infection who received chemotherapy from 1999 to 2010. All of the patients included in this analysis were classified as Child-Pugh A.

RESULTS

Among 32 patients with HBV infection who underwent chemotherapy (total cycles, 378), 3 experienced grade 3/4 hepatotoxicities, requiring 2 treatment delays and 1 treatment revision. Further, 9 patients experienced grade 3/4 hematotoxicities; of these, 2 required treatment delays and 3 required treatment revisions. Fifty-two HCV patients underwent a total of 570 cycles of chemotherapy. Five patients experienced grade 3/4 hepatotoxicities and required treatment delays, whereas 10 patients experienced grade 3 hematotoxicities; 3 of these patients required treatment delays.

CONCLUSION

Hematotoxicities requiring chemotherapy dose or treatment revision were not highly prevalent among breast cancer chemotherapy patients with HBV or HCV infection and a normal range of liver function. Under careful monitoring, chemotherapy dosage or schedule adjustments may not be necessary in similar patients positive for HBV or HCV.

摘要

背景

患有乙型肝炎（HBV）或丙型肝炎（HCV）病毒的乳腺癌化疗患者的血液学毒性信息有限。

方法

我们回顾性分析了 1999 年至 2010 年期间接受化疗的 HBV 或 HCV 感染的乳腺癌患者的肝毒性（即天冬氨酸转氨酶、丙氨酸转氨酶、碱性磷酸酶和胆红素升高）和血液学毒性（即白细胞减少和血小板减少）的发生情况。所有纳入分析的患者均为 Child-Pugh A 级。

结果

在 32 例接受化疗的 HBV 感染患者（总周期数为 378 个）中，有 3 例发生 3/4 级肝毒性，需要 2 次治疗延迟和 1 次治疗修改。此外，有 9 例发生 3/4 级血液学毒性；其中 2 例需要治疗延迟，3 例需要治疗修改。52 例 HCV 患者共接受 570 个化疗周期。有 5 例患者发生 3/4 级肝毒性，需要治疗延迟，10 例患者发生 3 级血液学毒性；其中 3 例患者需要治疗延迟。