がん化学療法による好中球減少症のリスクファクターに関する研究

Abstract

Because neutropenia involves susceptibility to severe infection, appropriate management of neutropenia is required during cancer chemotherapy. Assessing individual patients’ background to identify those at high risk is an important step. A systematic review of the literature was performed to overview recent findings about neutropenia risk factors. Type of cancer, treatment regimen, patient age, gender, performance status, comorbidities, laboratory abnormalities, prior therapies and some genetic polymorphisms were reported as risk factors for neutropenic complications.We have reported novel findings on the risk factor of severe neutropenia by using a pharmacoepidemiologic approach. One of them clarifies the increased risk by drug-drug interaction between vinorelbine and clarithromycin. Patients who were administered clarithromycin during chemotherapy with vinorelbine were at 4.52-times higher risk for severe neutropenia compared with patients who were administered vinorelbine alone. Another study reveals ethnic diversity in docetaxel toxicity between Asian and non-Asian clinical studies using integrated analysis of published articles. Clinical trials conducted in Asia had 19.0 times higher risk on severe neutropenia compared with non-Asian trials. Pharmacists and clinicians should mention such ethnic diversity.Like our studies, a pharmacoepidemiologic approach is useful for the clinical pharmacists’ study that aims to identify risk factors on pharmacotherapy.