Analysis of relative factors of bone marrow suppression after chemotherapy with carboplatin and paclitaxel on the patients with ovarian cancer

Abstract

To analyze the relative factors of bone marrow suppression after chemotherapy with different-dose carboplatin and paclitaxel (TC) on the patients with ovarian cancer. Sixty-two patients with ovarian cancer admitted in Beijing Obstetrics and Gynecology Hospital from January 2002 to December 2007, using TC regimen, a total of 196 cycles of chemotherapy, were divided into two groups by the doses of carboplatin [area under concentration-time curve (AUC) 4 - 6 for low-dose, AUC > 6 - 7 for hight-dose, the carboplatin dose calculated with AUC] or by the doses of paclitaxel (135- < 150 mg/m(2) low-dose, 150 - 175 mg/m(2) hight-dose). After each TC cycle, the routine blood was test to determine the graduation of the marrow suppression, and then the correlation factors were analyzed with logistic regression. (1) The occurrence rate of bone marrow suppression: there were 159 cycles (81.1%) grade 0-II bone marrow suppression, while 37 cycles (18.9%) of grade III-IV. (2) Factors related to bone marrow suppression: the results shown that there were not related to bone marrow suppression, which incluced cellular differentiation, tumor type, height, weight and paclitaxel dose (P > 0.05). While, the different cycle, age, the later stages of tumor, serum creatinine concentration, endogenous creatinine clearance rate, AUC values were the relative factors of bone marrow suppression (P = 0.000, 0.000, 0.018, 0.033, 0.001, 0.000). Seven variables were conducted into the logistic regression and the results shown that the different cycles, the age, AUC grades were independent risk factors (P = 0.030, 0.043, 0.009). (3) When low-dose of paclitaxel was given, the occurrence of bone marrow suppression was related to the carboplatin dose AUC. The higher AUC values for carboplatin were chosen, the higher of severe bone marrow suppression would happen. (4/14 vs 0, P = 0.015). When the dose of high grade of paclitaxel was given, the occurrence of bone marrow suppression in cases with hight-dose carboplatin was statistically significant than that in cases treated with low-dose carboplatin [45.7% (16/35) vs 13.7% (17/124), P = 0.000]. The independent risk factors of myelosuppression after chemotherapy with TC regime on the patients with ovarian cancer including the cycles, age and AUC values. The carboplatin dose calculating with AUC is related to the occurrence of bone marrow suppression, the higher AUC values for carboplatin would chosen, the higher of severe bone marrow suppression would be happen.