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Titolo:
Factors that predict chemotherapy-induced myelosuppression in lymphoma patients: Role of the tumor necrosis factor ligand-receptor system
Autore:
Voog, E; Bienvenu, J; Warzocha, K; Moullet, I; Dumontet, C; Thieblemont, C; Monneret, G; Gutowski, MC; Coiffier, B; Salles, G;
Indirizzi:
Ctr Hosp Lyon Sud, Serv Hematol, F-69495 Pierre Benite, France Ctr Hosp Lyon Sud Pierre Benite France F-69495 495 Pierre Benite, France Ctr Hosp Lyon Sud, Immunol Lab, F-69495 Pierre Benite, France Ctr Hosp Lyon Sud Pierre Benite France F-69495 495 Pierre Benite, France Univ Lyon 1, Jeune Equipe Pathol Cellules Lymphoides, F-69365 Lyon, FranceUniv Lyon 1 Lyon France F-69365 ellules Lymphoides, F-69365 Lyon, France
Titolo Testata:
JOURNAL OF CLINICAL ONCOLOGY
fascicolo: 2, volume: 18, anno: 2000,
pagine: 325 - 331
SICI:
0732-183X(200001)18:2<325:FTPCMI>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
INCREASED SERUM LEVELS; NON-HODGKINS-LYMPHOMA; FACTOR-ALPHA; SOLUBLE RECEPTORS; TNF-ALPHA; INTENSIVE CHEMOTHERAPY; CANCER-PATIENTS; RISK FACTOR; NEUTROPENIA; INFLAMMATION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
30
Recensione:
Indirizzi per estratti:
Indirizzo: Salles, G Ctr Hosp Lyon Sud, Serv Hematol, F-69495 Pierre Benite, France Ctr Hosp Lyon Sud Pierre Benite France F-69495 Benite, France
Citazione:
E. Voog et al., "Factors that predict chemotherapy-induced myelosuppression in lymphoma patients: Role of the tumor necrosis factor ligand-receptor system", J CL ONCOL, 18(2), 2000, pp. 325-331

Abstract

Purpose: To analyze factors that predict the occurrence of chemotherapy-induced myelosuppression and, in particular, the role of the tumor necrosis factor (TNF) ligand-receptor system in lymphoma patients at the beginning oftheir treatment. Patients and Methods: We investigated the predictive factors for myelosuppression after the first course of chemotherapy in a cohort of 101 consecutive, previously untreated lymphoma patients receiving regimens that include doxorubicin and cyclophosphamide. Plasma samples were tested at baseline byenzyme-linked immunosorbent assay for TNF and its soluble receptors. Univariate and multivariate analyses were performed with a forward regression procedure that included all of the parameters that were found to be significant in the univariate analysis. The dose of chemotherapy and the prophylactic treatment with granulocyte colony-stimulating factor were deliberately included in this model. Results: Sixty-seven patients experienced World Health Organization (WHO) grade 4 neutropenia, and 37 patients experienced febrile neutropenia, whichwas responsible for WHO grade 2 through 4 infections in 23 patients. In multiparametric regression analysis, the occurrence of grade 4 neutropenia was associated with high doses of cyclophosphamide (odds ratio [OR], 19.8; P = .008) and high levels of soluble p75-R-TNF (OR, 8.52; P = .001). The duration of grade 4 neutropenia for more than 5 days was associated with the lack of hematopoietic growth factor administration (OR, 6.76; P = .004) and high levels of soluble p75-R-TNF (OR, 5.84; P = .0023). The occurrence of febrile neutropenia was associated with high doses of cyclophosphamide (OR, 4.7; P = .007), altered performance status (OR, 18.8; P < .0001) and high levels of soluble p75-R-TNF (OR, 3.49; P = .029). Conclusion: This study indicates that in addition to the dose of chemotherapy and the administration of hematopoietic growth factors, poor performance status and high p75-R-TNF levels can predict the occurrence of chemotherapy-induced myelosuppression in lymphoma patients. This model may help in selecting patients for prophylactic growth factor administration. (C) 2000 byAmerican Society of Clinical Oncology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/07/20 alle ore 21:08:40