Gaumond Simonetta I, Lee Karen J, Warp Peyton V, Kamholtz Isabella, Dreifus Emilee M, Jimenez Joaquin J
Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
Cancers (Basel). 2025 Mar 30;17(7):1163. doi: 10.3390/cancers17071163.
Chemotherapy-induced neutropenia (CIN) and chemotherapy-induced alopecia (CIA) are significant toxicities affecting cancer patients. CIN is a potentially fatal complication of chemotherapy caused by myelosuppression and increased infection susceptibility, while CIA, although not fatal, severely affects treatment adherence and mental health. This study provides a comprehensive comparative analysis of CIN and CIA, focusing on patient, disease, treatment, and genetic risk factors. Key risk factors for CIN and CIA include age, poor performance status, body mass index (BMI), laboratory abnormalities, and pre-existing comorbidities. Both toxicities were significantly associated with breast cancer patients, although CIN patients were more likely to have hematological cancer, and CIA patients were more likely to have solid tumors. Notably, anthracyclines, alkylators, and taxanes frequently induce both toxicities, although their timelines and clinical implications differed. There was no clear overlap between genetic predispositions and toxicities beyond single-nucleotide polymorphisms (SNPs) in the ABCB1 gene. This is the first study to directly compare CIN and CIA, offering insights into personalized oncology care. Understanding the risk factors implicated in the development of CIN and CIA will enable physicians to manage patient outcomes.
化疗引起的中性粒细胞减少症（CIN）和化疗引起的脱发（CIA）是影响癌症患者的重要毒性反应。CIN是化疗的一种潜在致命并发症，由骨髓抑制和感染易感性增加引起，而CIA虽然不致命，但严重影响治疗依从性和心理健康。本研究对CIN和CIA进行了全面的比较分析，重点关注患者、疾病、治疗和遗传风险因素。CIN和CIA的关键风险因素包括年龄、身体状况差、体重指数（BMI）、实验室异常和既往合并症。这两种毒性反应均与乳腺癌患者显著相关，不过CIN患者更易患血液系统癌症，而CIA患者更易患实体瘤。值得注意的是，蒽环类药物、烷化剂和紫杉烷类药物常常会引发这两种毒性反应，尽管它们的发生时间和临床意义有所不同。除了ABCB1基因中的单核苷酸多态性（SNP）外，遗传易感性与毒性反应之间没有明显的重叠。这是第一项直接比较CIN和CIA的研究，为个性化肿瘤治疗提供了见解。了解与CIN和CIA发生相关的风险因素将使医生能够管理患者的治疗结果。
