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老年淋巴瘤患者化疗相关毒性的预测因素:来自三级癌症中心的经验

Predictors of Chemotherapy Related Toxicities in Elderly Lymphoma Patients: Experience from a Tertiary Cancer Centre.

作者信息

Mishra Sourav, Radhakrishnan Venkatraman, Ganesan Prasanth, Rajendranath Rejiv, Rajaraman Swaminathan, Ganesan Trivadi S, Sagar Tenali Gnana

机构信息

Department of Medical Oncology, Cancer Institute (WIA), Adyar, Chennai, 600020 India.

Department of Epidemiology, Cancer Institute (WIA), Adyar, Chennai, India.

出版信息

Indian J Hematol Blood Transfus. 2017 Dec;33(4):470-476. doi: 10.1007/s12288-017-0794-z. Epub 2017 Feb 25.

Abstract

Identification of baseline parameters that predict chemotherapy related morbidities in elderly lymphoma patients can help in tailoring treatment. However, there is a paucity of tools to predict the risk of chemotherapy related toxicity in elderly lymphoma patients from India. We retrospectively analyzed 203 lymphoma patients more than 60 years of age for predictors of grade III or higher haematological and non-haematological toxicity due to chemotherapy. Eighty-five (42%) and seventy-one (35%) lymphoma patients developed grade III or IV haematological and non-haematological toxicities respectively. On multivariate analysis baseline absolute lymphocyte counts (ALC) less than 1300/µl, chemotherapy with anthracyclines and presence of two co-morbid conditions were significant in predicting serious haematological toxicities. For non-haematological toxicities baseline ALT levels more than 40 U/l was the only significant factor. This is the first report from India on the study of factors predicting serious chemotherapy related adverse effects in elderly lymphoma patients. Patients with low ALC, elevated ALT, multiple co-morbidities and receiving anthracyclines should be closely monitored for chemotherapy related toxicities.

摘要

识别能够预测老年淋巴瘤患者化疗相关发病率的基线参数有助于调整治疗方案。然而,在印度,用于预测老年淋巴瘤患者化疗相关毒性风险的工具却很匮乏。我们对203例60岁以上的淋巴瘤患者进行了回顾性分析,以寻找化疗导致的III级或更高级别血液学和非血液学毒性的预测因素。分别有85例(42%)和71例(35%)淋巴瘤患者发生了III级或IV级血液学和非血液学毒性。多因素分析显示,基线绝对淋巴细胞计数(ALC)低于1300/µl、使用蒽环类药物化疗以及存在两种合并症是预测严重血液学毒性的重要因素。对于非血液学毒性,基线谷丙转氨酶(ALT)水平高于40 U/l是唯一的重要因素。这是印度首份关于预测老年淋巴瘤患者严重化疗相关不良反应因素的研究报告。对于ALC低、ALT升高、合并多种疾病且接受蒽环类药物治疗的患者,应密切监测其化疗相关毒性。

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