Abstract
PurposeIn clinical practice, the risk factors for pegylated liposomal doxorubicin-related hand-foot syndrome remain unclear. The purpose of this study was to determine the risk factors associated with hand-foot syndrome in patients with lymphoma using pegylated liposomal doxorubicin.MethodsThis retrospective descriptive analysis included patients with lymphoma who received PLD treatment (≥ 2 cycles of chemotherapy) at our cancer centre and had complete follow-up data from January 2016 to February 2020. Clinical, laboratory data, as well as the occurrence of hand-foot syndrome (incidence, location, severity, impact on follow-up chemotherapy) were obtained. The primary end point was the incidence of hand-foot syndrome, which was classified according to the “Common Terminology Criteria for Adverse Events” (Version 4.0). A multivariate logistic regression analysis was used to identify risk factors for hand-foot syndrome in patients with lymphoma using doxorubicin liposomes.FindingsA total of 167 patients met the inclusion criteria. 58 developed HFS, of which 45 occurred after the second course of chemotherapy. The multivariate logistic regression analysis revealed that a dose increase of pegylated liposomal doxorubicin and hepatobiliary dysfunction were significantly associated with an increased risk for hand-foot syndrome(dose intensity, OR = 6.479; 95% CI, 1.431–29.331 [P = 0.015]; history of gallstones, OR = 14.144, 95% CI, 1.512–132.346 [P = 0.020]; alanine aminotransferase, OR = 1.194, 95% CI, 1.056–1.350 [P = 0.005]; aspartate aminotransferase, OR = 1.162, 95% CI, 1.010–1.336 [P = 0.035]; and glutamine transpeptidase, OR = 1.092, 95% CI, 1.016–1.174 [P = 0.018]).ImplicationsThese findings contribute to the risk assessment of patients with lymphoma before using pegylated liposomal doxorubicin. For patients with the above risk factors, preventive measures should be taken in advance to reduce the incidence of HFS.
Highlights
Anthracycline drugs have significant therapeutic activity in a variety of cancer types [1] and are important in the treatment of lymphoma
Before intravenous Pegylated liposomal doxorubicin (PLD), the patients were given dexamethasone 10 mg intravenously or oral prednisone according to the chemotherapy regimen to prevent allergic reactions
The study group consisted of 167 patients with lymphoma who received PLD treatment (≥ 2 cycles of chemotherapy)
Summary
Anthracycline drugs have significant therapeutic activity in a variety of cancer types [1] and are important in the treatment of lymphoma. The effectiveness of these drugs (especially doxorubicin) is limited by substantial toxicity. Doxorubicin can cause cumulative damage to the heart muscle, and most of it is irreversible damage, which limits the repeated use of the drug [2]. PLD is used as a drug for the treatment of various malignancies, including AIDS-related Kaposi’s sarcoma, ovarian cancer, lymphoma, metastatic breast cancer, and multiple myeloma [5]. Compared with conventional anthracycline drugs, the circulation time of PLD is long, its payload remains stable, and its accumulation in tumours with high vascular permeability has important advantages. The ability of PLD to reduce many of the adverse side effects of doxorubicin (including reducing cardiotoxicity) is clear, but the subsequent emergence of special adverse reactions (such as hypersensitivity, mucositis, and hand-foot syndrome) has undoubtedly added to clinicians’ concerns about the use of PLD
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