761 PREDICTION OF LEUKOPENIA AFTER DOCETAXEL CHEMOTHERAPY IN PATIENTS WITH CASTRATION-RESISTANT PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Advanced II1 Apr 2012761 PREDICTION OF LEUKOPENIA AFTER DOCETAXEL CHEMOTHERAPY IN PATIENTS WITH CASTRATION-RESISTANT PROSTATE CANCER Jun Nakashima, Issei Takizawa, Kazuyoshi Ko, Yoshihiro Nakagami, Makoto Ohori, Yoshio Ohno, Kunihiko Yoshioka, and Masaaki Tachibana Jun NakashimaJun Nakashima Tokyo, Japan More articles by this author , Issei TakizawaIssei Takizawa Tokyo, Japan More articles by this author , Kazuyoshi KoKazuyoshi Ko Tokyo, Japan More articles by this author , Yoshihiro NakagamiYoshihiro Nakagami Tokyo, Japan More articles by this author , Makoto OhoriMakoto Ohori Tokyo, Japan More articles by this author , Yoshio OhnoYoshio Ohno Tokyo, Japan More articles by this author , Kunihiko YoshiokaKunihiko Yoshioka Tokyo, Japan More articles by this author , and Masaaki TachibanaMasaaki Tachibana Tokyo, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.848AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Leukopenia is a major adverse toxicity of docetaxel (DTX) chemotherapy. The present study was undertaken to evaluate the incidence of leukopenia and to develop a risk-factor-based prediction model for leukopenia after DTX chemotherapy in patients with castration-resistant prostate cancer (CRPC). METHODS This study included 81 patients with CRPC treated with 70 mg/m2 DTX on day 2. 560 mg estramustine phosphate for the first 5 days, 8 mg dexamethasone on days 1 to 3 and daily hydrocortisone. According to the CTCAE, grade3/4 leukopenia were defined by the WBC count less than 2000 and 1000, respectively. We evaluated the incidence and risk factors of grade3/4 leukopenia in the first cycle of the chemotherapy. A risk-factor-based model predicting grade3/4 leukopenia was developed from a multivariate logistic regression analysis. RESULTS The mean age was 70.6±0.7. Fourty four of 82 patients (54%) developed grade3/4 leukopenia in the first cycle of DTX chemotherapy. There were significant differences in age (68.5±1.0 vs 72.8±0.8, p=0.0026), pretreatment WBC count (7526±305 vs 6511±262, p=0.0375), neutrophil count (5326±292 vs 4534±232, p=0.0217) between patients with grade≤2 and with grade3/4 leukopenia. On the other hand, hemoglobin (Hb) levels, platelet count and serum PSA levels, creatinine, albumin and LDH at the initiation of the chemotherapy and histology, EOD on bone scan and serum PSA at the initial diagnosis were not significantly different between the two groups. The incidence of grade3/4 leukopenia was significantly greater in patients with age≥68, WBC<5500, neutrophil<5000, lymphocyte<1400 and Hb<11g/dl at the initiation of the chemotherapy than their respective counterparts. Multivariate logistic analysis showed that WBC<5500 and age were significant independent risk factors for grade3/4 leukopenia. The predicted probability of grade3/4 leukopenia was estimated as P=1/(1+exp[-k]), where k is -9.606 + 0.135x1 + 1.791x2, x1 is age and x2=1 if WBC<5500, x2=0 if not (Figure). CONCLUSIONS Pretreatment WBC count and age were significant independent risk factors for grade 3/4 leukopenia. The nomogram to predict docetaxel-induced leukopenia may provide useful information for the postchemotherapy management in patients with CRPC treated with docetaxel chemotherapy. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e311 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jun Nakashima Tokyo, Japan More articles by this author Issei Takizawa Tokyo, Japan More articles by this author Kazuyoshi Ko Tokyo, Japan More articles by this author Yoshihiro Nakagami Tokyo, Japan More articles by this author Makoto Ohori Tokyo, Japan More articles by this author Yoshio Ohno Tokyo, Japan More articles by this author Kunihiko Yoshioka Tokyo, Japan More articles by this author Masaaki Tachibana Tokyo, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...