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基于单核细胞百分比预测多西他赛单药治疗引起的中性粒细胞减少症。

Prediction of docetaxel monotherapy-induced neutropenia based on the monocyte percentage.

作者信息

Sato Itaru, Nakaya Naoki, Shimasaki Takeo, Nakajima Hideo, Motoo Yoshiharu

机构信息

Department of Medical Oncology/Multidisciplinary Cancer Center, Kanazawa Medical University,Daigaku, Uchinada-Machi, Kahoku-Gun, Ishikawa 920-0293, Japan.

出版信息

Oncol Lett. 2012 Apr 1;3(4):860-864. doi: 10.3892/ol.2012.556. Epub 2012 Jan 9.

Abstract

We retrospectively reviewed the medical records of 32 chemonaïve patients with either breast, lung or prostate cancer, who were treated with docetaxel (DOC) monotherapy, and evaluated whether the proportion of peripheral blood monocytes was capable of predicting the occurrence of neutropenia following chemotherapy. In the granulocyte-colony stimulating factor (G-CSF) non‑administration group, the monocyte percentage was inversely correlated with the decrease in neutrophils (P=0.01; corrected correlation coefficient, -0.71). The neutrophil count decreased by ≥30% in 7 of 8 patients with <5% monocytes, whereas it decreased by >30% in 1 of 6 patients with ≥5% monocytes (P=0.01). Three of 8 patients with <5% monocytes experienced grade 4 neutropenia, while in the group with ≥5% monocytes, 1 of 6 patients experienced grade 4 neutropenia. The frequency of grade 3 or 4 neutropenia was lower in patients with ≥5% monocytes than in patients with <5% monocytes, but the difference was not significant (P=0.41). Following G-CSF administration, grade 3 or 4 neutropenia had the tendency of lasting longer in patients with <5% monocytes than in those with ≥5% monocytes; however, the monocyte percentage was not correlated with the grade of neutropenia (P=0.34). The monocyte percentage following chemotherapy was inversely correlated with the decrease in neutrophils. The percentage of monocytes that are available in clinical practice may be predictive of neutropenia following chemotherapy. Our findings suggest that patients with <5% monocytes following DOC monotherapy are at risk of severe neutropenia and should be carefully monitored.

摘要

我们回顾性分析了32例初治的乳腺癌、肺癌或前列腺癌患者的病历,这些患者接受了多西他赛(DOC)单药治疗,并评估外周血单核细胞比例是否能够预测化疗后中性粒细胞减少的发生情况。在未使用粒细胞集落刺激因子(G-CSF)的组中,单核细胞百分比与中性粒细胞减少呈负相关(P = 0.01;校正相关系数,-0.71)。8例单核细胞<5%的患者中有7例中性粒细胞计数下降≥30%,而6例单核细胞≥5%的患者中有1例中性粒细胞计数下降>30%(P = 0.01)。8例单核细胞<5%的患者中有3例发生4级中性粒细胞减少,而在单核细胞≥5%的组中,6例患者中有1例发生4级中性粒细胞减少。单核细胞≥5%的患者3/4级中性粒细胞减少的发生率低于单核细胞<5%的患者,但差异无统计学意义(P = 0.41)。给予G-CSF后,单核细胞<5%的患者3/4级中性粒细胞减少持续时间有长于单核细胞≥5%患者的趋势;然而,单核细胞百分比与中性粒细胞减少的分级无关(P = 0.34)。化疗后的单核细胞百分比与中性粒细胞减少呈负相关。临床实践中可获得的单核细胞百分比可能预测化疗后中性粒细胞减少。我们的研究结果表明,DOC单药治疗后单核细胞<5%的患者有发生严重中性粒细胞减少的风险,应仔细监测。

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