Zhang Yuling, Guo Pi, Huang Xiaoting, Xu Yi-Wei, Zheng Zhiwei, Fang Ling
Research Institute of Clinical Pharmacy, Shantou University Medical College, Shantou, Guangdong, China.
Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, China.
PeerJ. 2025 May 12;13:e19375. doi: 10.7717/peerj.19375. eCollection 2025.
Many studies have focused on adverse reactions caused by platinum drugs but neglected subsequent toxicities and the mechanisms during patient recovery after chemotherapy with different platinum drugs, which need attention because of the heavy metal platinum.
We aimed to explore the correlations between platinum accumulation, hematological indices, and clinical toxicity in patients after a metabolism period following platinum drug chemotherapy, to better understand real-world clinical toxicity caused by platinum accumulation.
We enrolled patients receiving platinum chemotherapy, specifically cisplatin, oxaliplatin, or carboplatin. On the 25th day post-chemotherapy, we measured serum platinum concentrations and hematological indices, documented clinical toxicities, and subsequently performed correlation analyses.
The serum platinum concentrations in oxaliplatin-, cisplatin-, and carboplatin-treated patients were 208.60, 349.15 and 211.30 µg/L ( = 51.755, < 0.001), respectively. Mediation effect analysis showed that decreased erythrocyte, hemoglobin and glutamic-pyruvic transaminase individually mediated 21.39, 12.0 and 10.94%, respectively, of the platinum positive effect on fatigue. Decreased erythrocyte counts mediated 5.89%, while increased creatinine mediated 5.2% of the platinum positive effect on adverse reactions. The cutoff values of hematological indices, the risk of adverse reactions and fatigue were also obtained in this research which will be applied in clinical practice.
Platinum accumulation, by disrupting the red blood cell system and liver and kidney function, influences fatigue severity and common adverse reactions in patients during the post-chemotherapy recovery period.
许多研究聚焦于铂类药物引起的不良反应，但忽视了不同铂类药物化疗后患者恢复过程中的后续毒性及机制，鉴于重金属铂的存在，这些需要引起关注。
我们旨在探讨铂类药物化疗代谢期后患者体内铂蓄积、血液学指标与临床毒性之间的相关性，以更好地了解铂蓄积所致的真实世界临床毒性。
我们纳入接受铂类化疗的患者，具体为顺铂、奥沙利铂或卡铂。化疗后第25天，我们测量血清铂浓度和血液学指标，记录临床毒性，随后进行相关性分析。
奥沙利铂、顺铂和卡铂治疗患者的血清铂浓度分别为208.60、349.15和211.30µg/L（F = 51.755，P < 0.001）。中介效应分析表明，红细胞、血红蛋白和谷丙转氨酶降低分别介导了铂对疲劳正向效应的21.39%、12.0%和10.94%。红细胞计数降低介导了铂对不良反应正向效应的5.89%，而肌酐升高介导了5.2%。本研究还获得了血液学指标的截断值、不良反应和疲劳风险，将应用于临床实践。
铂蓄积通过破坏红细胞系统及肝肾 功能，影响化疗后恢复期患者的疲劳严重程度和常见不良反应。
