Risk factors for severe neutropenia following intra-arterial chemotherapy for intra-ocular retinoblastoma Journal Article
| Authors: | Dunkel, I. J.; Shi, W.; Salvaggio, K.; Marr, B. P.; Brodie, S. E.; Gobin, Y. P.; Abramson, D. H. |
| Article Title: | Risk factors for severe neutropenia following intra-arterial chemotherapy for intra-ocular retinoblastoma |
| Abstract: | Purpose: Intra-arterial chemotherapy is a promising strategy for intra-ocular retinoblastoma. Neutropenia is the most commonly encountered systemic toxicity and in this study we aimed to determine the risk factors associated with the development of severe (≥grade 3) neutropenia. Methods: Retrospective review of 187 evaluable cycles of melphalan-containing intra-arterial chemotherapy from the first three cycles administered to 106 patients with intra-ocular retinoblastoma from May 2006 to June 2011. Cycles were considered to be evaluable if (1) blood count results were available in the 7 to 14 days post-treatment interval and (2) concurrent intravenous chemotherapy was not administered. Toxicity was assessed via the Common Terminology Criteria for Adverse Events version 4.0. Results: 54 cycles (29%) were associated with grade 3 (n = 43) or grade 4 (n = 11) neutropenia. Multivariate stepwise logistic regression revealed that a higher melphalan dose (>0.40 mg/kg) was significantly associated with severe neutropenia during all 3 cycles (odds ratio during cycle one 4.11, 95% confidence interval 1.33-12.73, p = 0.01), but the addition of topotecan and/or carboplatin were not. Prior treatment with systemic chemotherapy was not associated with severe neutropenia risk in any analysis. Conclusions: Intra-arterial melphalan-based chemotherapy can cause severe neutropenia, especially when a dose of greater than 0.40 mg/kg is administered. Further study with a larger sample may be warranted. |
| Keywords: | controlled study; major clinical study; clinical feature; neutropenia; drug efficacy; drug safety; topotecan; carboplatin; multiple cycle treatment; anemia; mucosa inflammation; thrombocytopenia; melphalan; retinoblastoma; retrospective study; risk factor; fever; drug antagonism; disease severity; blood cell count; intraocular retinoblastoma; human; article |
| Journal Title: | PLoS ONE |
| Volume: | 9 |
| Issue: | 10 |
| ISSN: | 1932-6203 |
| Publisher: | Public Library of Science |
| Date Published: | 2014-10-10 |
| Start Page: | e108692 |
| Language: | English |
| DOI: | 10.1371/journal.pone.0108692 |
| PROVIDER: | scopus |
| PMCID: | 25303673 |
| PUBMED: | PMC4193762 |
| DOI/URL: | |
| Notes: | Export Date: 3 November 2014 -- Source: Scopus |
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