Risk factors for predicting severe neutropenia induced by pemetrexed plus carboplatin therapy in patients with advanced non-small cell lung cancer

Hiroaki Ikesue, Hiroyuki Watanabe, Megumi Hirano, Ayako Chikamori, Kimitaka Suetsugu, Yuriko Ryokai, Nobuaki Egashira, Tsuyoshi Yamada, Munehiko Ikeda, Eiji Iwama, Taishi Harada, Koichi Takayama, Yoichi Nakanishi, Satohiro Masuda

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Pemetrexed plus carboplatin therapy is widely administered to patients with non-squamous non-small cell lung cancer. Although severe neutropenia is often observed during this combination therapy, its predictive factors are unknown. Therefore, we investigated the predictive factors for severe neutropenia in 77 patients treated with this combination therapy at the Department of Respiratory Medicine, Kyushu University Hospital, between September 2009 and September 2013. All data were retrospectively collected from the electronic medical record system, and univariate and multivariate logistic regression analyses were performed to identify risk factors for grade 3 or 4 neutropenia. Among the 77 patients, 34 (44%) developed grade 3 or 4 neutropenia. Multivariate analysis revealed that lower baseline hemoglobin values (odds ratio [OR], 1.97 per 1 g/dL decrease; 95% confidence interval [CI], 1.39-2.99, p<0.01) and lower baseline neutrophil counts (OR, 1.71 per 1000/mm3 decrease; 95% CI, 1.14-2.71, p=0.01) were significantly associated with grade 3 or 4 neutropenia. During 4 courses of pemetrexed plus carboplatin therapy, the incidence of grade 3 or 4 neutropenia in patients with baseline hemoglobin values of <11.6 g/dL was significantly higher than that in patients with values of ≥11.6 g/dL [84% (16/19) vs. 31% (18/58), p<0.001]. In conclusion, patients with lower baseline neutrophil counts or lower baseline hemoglobin values, especially those with baseline hemoglobin values of <11.6 g/dL, should be monitored more carefully during pemetrexed plus carboplatin therapy.

Original languageEnglish
Pages (from-to)1192-1198
Number of pages7
JournalBiological and Pharmaceutical Bulletin
Volume38
Issue number8
DOIs
Publication statusPublished - Aug 1 2015

Fingerprint

Pemetrexed
Carboplatin
Neutropenia
Non-Small Cell Lung Carcinoma
Hemoglobins
Neutrophils
Therapeutics
Odds Ratio
Confidence Intervals
Pulmonary Medicine
Electronic Health Records
Multivariate Analysis
Logistic Models
Regression Analysis
Incidence

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Pharmaceutical Science

Cite this

Risk factors for predicting severe neutropenia induced by pemetrexed plus carboplatin therapy in patients with advanced non-small cell lung cancer. / Ikesue, Hiroaki; Watanabe, Hiroyuki; Hirano, Megumi; Chikamori, Ayako; Suetsugu, Kimitaka; Ryokai, Yuriko; Egashira, Nobuaki; Yamada, Tsuyoshi; Ikeda, Munehiko; Iwama, Eiji; Harada, Taishi; Takayama, Koichi; Nakanishi, Yoichi; Masuda, Satohiro.

In: Biological and Pharmaceutical Bulletin, Vol. 38, No. 8, 01.08.2015, p. 1192-1198.

Research output: Contribution to journalArticle

Ikesue, H, Watanabe, H, Hirano, M, Chikamori, A, Suetsugu, K, Ryokai, Y, Egashira, N, Yamada, T, Ikeda, M, Iwama, E, Harada, T, Takayama, K, Nakanishi, Y & Masuda, S 2015, 'Risk factors for predicting severe neutropenia induced by pemetrexed plus carboplatin therapy in patients with advanced non-small cell lung cancer', Biological and Pharmaceutical Bulletin, vol. 38, no. 8, pp. 1192-1198. https://doi.org/10.1248/bpb.b15-00162
Ikesue, Hiroaki ; Watanabe, Hiroyuki ; Hirano, Megumi ; Chikamori, Ayako ; Suetsugu, Kimitaka ; Ryokai, Yuriko ; Egashira, Nobuaki ; Yamada, Tsuyoshi ; Ikeda, Munehiko ; Iwama, Eiji ; Harada, Taishi ; Takayama, Koichi ; Nakanishi, Yoichi ; Masuda, Satohiro. / Risk factors for predicting severe neutropenia induced by pemetrexed plus carboplatin therapy in patients with advanced non-small cell lung cancer. In: Biological and Pharmaceutical Bulletin. 2015 ; Vol. 38, No. 8. pp. 1192-1198.
@article{d9f6f5d826bc42818b6deb539c1ad11b,
title = "Risk factors for predicting severe neutropenia induced by pemetrexed plus carboplatin therapy in patients with advanced non-small cell lung cancer",
abstract = "Pemetrexed plus carboplatin therapy is widely administered to patients with non-squamous non-small cell lung cancer. Although severe neutropenia is often observed during this combination therapy, its predictive factors are unknown. Therefore, we investigated the predictive factors for severe neutropenia in 77 patients treated with this combination therapy at the Department of Respiratory Medicine, Kyushu University Hospital, between September 2009 and September 2013. All data were retrospectively collected from the electronic medical record system, and univariate and multivariate logistic regression analyses were performed to identify risk factors for grade 3 or 4 neutropenia. Among the 77 patients, 34 (44{\%}) developed grade 3 or 4 neutropenia. Multivariate analysis revealed that lower baseline hemoglobin values (odds ratio [OR], 1.97 per 1 g/dL decrease; 95{\%} confidence interval [CI], 1.39-2.99, p<0.01) and lower baseline neutrophil counts (OR, 1.71 per 1000/mm3 decrease; 95{\%} CI, 1.14-2.71, p=0.01) were significantly associated with grade 3 or 4 neutropenia. During 4 courses of pemetrexed plus carboplatin therapy, the incidence of grade 3 or 4 neutropenia in patients with baseline hemoglobin values of <11.6 g/dL was significantly higher than that in patients with values of ≥11.6 g/dL [84{\%} (16/19) vs. 31{\%} (18/58), p<0.001]. In conclusion, patients with lower baseline neutrophil counts or lower baseline hemoglobin values, especially those with baseline hemoglobin values of <11.6 g/dL, should be monitored more carefully during pemetrexed plus carboplatin therapy.",
author = "Hiroaki Ikesue and Hiroyuki Watanabe and Megumi Hirano and Ayako Chikamori and Kimitaka Suetsugu and Yuriko Ryokai and Nobuaki Egashira and Tsuyoshi Yamada and Munehiko Ikeda and Eiji Iwama and Taishi Harada and Koichi Takayama and Yoichi Nakanishi and Satohiro Masuda",
year = "2015",
month = "8",
day = "1",
doi = "10.1248/bpb.b15-00162",
language = "English",
volume = "38",
pages = "1192--1198",
journal = "Biological and Pharmaceutical Bulletin",
issn = "0918-6158",
publisher = "Pharmaceutical Society of Japan",
number = "8",

}

TY - JOUR

T1 - Risk factors for predicting severe neutropenia induced by pemetrexed plus carboplatin therapy in patients with advanced non-small cell lung cancer

AU - Ikesue, Hiroaki

AU - Watanabe, Hiroyuki

AU - Hirano, Megumi

AU - Chikamori, Ayako

AU - Suetsugu, Kimitaka

AU - Ryokai, Yuriko

AU - Egashira, Nobuaki

AU - Yamada, Tsuyoshi

AU - Ikeda, Munehiko

AU - Iwama, Eiji

AU - Harada, Taishi

AU - Takayama, Koichi

AU - Nakanishi, Yoichi

AU - Masuda, Satohiro

PY - 2015/8/1

Y1 - 2015/8/1

N2 - Pemetrexed plus carboplatin therapy is widely administered to patients with non-squamous non-small cell lung cancer. Although severe neutropenia is often observed during this combination therapy, its predictive factors are unknown. Therefore, we investigated the predictive factors for severe neutropenia in 77 patients treated with this combination therapy at the Department of Respiratory Medicine, Kyushu University Hospital, between September 2009 and September 2013. All data were retrospectively collected from the electronic medical record system, and univariate and multivariate logistic regression analyses were performed to identify risk factors for grade 3 or 4 neutropenia. Among the 77 patients, 34 (44%) developed grade 3 or 4 neutropenia. Multivariate analysis revealed that lower baseline hemoglobin values (odds ratio [OR], 1.97 per 1 g/dL decrease; 95% confidence interval [CI], 1.39-2.99, p<0.01) and lower baseline neutrophil counts (OR, 1.71 per 1000/mm3 decrease; 95% CI, 1.14-2.71, p=0.01) were significantly associated with grade 3 or 4 neutropenia. During 4 courses of pemetrexed plus carboplatin therapy, the incidence of grade 3 or 4 neutropenia in patients with baseline hemoglobin values of <11.6 g/dL was significantly higher than that in patients with values of ≥11.6 g/dL [84% (16/19) vs. 31% (18/58), p<0.001]. In conclusion, patients with lower baseline neutrophil counts or lower baseline hemoglobin values, especially those with baseline hemoglobin values of <11.6 g/dL, should be monitored more carefully during pemetrexed plus carboplatin therapy.

AB - Pemetrexed plus carboplatin therapy is widely administered to patients with non-squamous non-small cell lung cancer. Although severe neutropenia is often observed during this combination therapy, its predictive factors are unknown. Therefore, we investigated the predictive factors for severe neutropenia in 77 patients treated with this combination therapy at the Department of Respiratory Medicine, Kyushu University Hospital, between September 2009 and September 2013. All data were retrospectively collected from the electronic medical record system, and univariate and multivariate logistic regression analyses were performed to identify risk factors for grade 3 or 4 neutropenia. Among the 77 patients, 34 (44%) developed grade 3 or 4 neutropenia. Multivariate analysis revealed that lower baseline hemoglobin values (odds ratio [OR], 1.97 per 1 g/dL decrease; 95% confidence interval [CI], 1.39-2.99, p<0.01) and lower baseline neutrophil counts (OR, 1.71 per 1000/mm3 decrease; 95% CI, 1.14-2.71, p=0.01) were significantly associated with grade 3 or 4 neutropenia. During 4 courses of pemetrexed plus carboplatin therapy, the incidence of grade 3 or 4 neutropenia in patients with baseline hemoglobin values of <11.6 g/dL was significantly higher than that in patients with values of ≥11.6 g/dL [84% (16/19) vs. 31% (18/58), p<0.001]. In conclusion, patients with lower baseline neutrophil counts or lower baseline hemoglobin values, especially those with baseline hemoglobin values of <11.6 g/dL, should be monitored more carefully during pemetrexed plus carboplatin therapy.

UR - http://www.scopus.com/inward/record.url?scp=84940912476&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84940912476&partnerID=8YFLogxK

U2 - 10.1248/bpb.b15-00162

DO - 10.1248/bpb.b15-00162

M3 - Article

C2 - 26235582

AN - SCOPUS:84940912476

VL - 38

SP - 1192

EP - 1198

JO - Biological and Pharmaceutical Bulletin

JF - Biological and Pharmaceutical Bulletin

SN - 0918-6158

IS - 8

ER -