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Published in: Supportive Care in Cancer 6/2015

01-06-2015 | Original Article

Can grade 2 neutropenia predict the risk of grade 3 neutropenia in metastatic colorectal cancer patients treated with chemotherapy?

Authors: Yoichiro Yoshida, Seiichiro Hoshino, Naoya Aisu, Ai Mogi, Teppei Yamada, Daibo Kojima, Syu Tanimura, Keiji Hirata, Yuichi Yamashita

Published in: Supportive Care in Cancer | Issue 6/2015

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Abstract

Purpose

Neutropenia is a major factor affecting continuation of chemotherapy for colorectal cancer. In many clinical trials, a neutrophil count of >1500 is targeted for continuation; for a count of <1500, medication is commonly discontinued. However, there is no definitive evidence supporting the need for a neutrophil count of 1500 for continuation of chemotherapy. In the clinical trials that we conducted, we discontinued chemotherapy when the neutrophil count was <1000 (grade 3); for a count of 1000–1500 (grade 2), chemotherapy was continued. Therefore, even practical treatment uses the same setting. Our aim was to examine neutrophil counts during continuation of chemotherapy in colorectal cancer patients with counts of 1000–1500 and to assess the need for discontinuation of medication for neutrophil counts in this range. Moreover, we examined neutrophil counts during the previous course of chemotherapy when they fell below 1000.

Methods

The study included 144 patients who received XELOX + bevacizumab therapy and XELOX therapy for advanced or recurrent colorectal cancer.

Results

Thirty (20.8 %) patients had neutrophil counts of 1000–1500. One (3.3 %) of 30 patients had a neutrophil count of <1000 during the following course of chemotherapy. Moreover, among the patients with neutrophil counts of <1000, 27.3 % had counts of 1000–1500 during the previous course of chemotherapy and 72.7 % had counts of >1500.

Conclusions

Based on these results, grade 2 neutropenia cannot predict the risk of grade 3 neutropenia. Continuation of chemotherapy in patients with neutrophil counts of 1000–1500 may be appropriate, and discontinuation of therapy is not always required.
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Metadata
Title
Can grade 2 neutropenia predict the risk of grade 3 neutropenia in metastatic colorectal cancer patients treated with chemotherapy?
Authors
Yoichiro Yoshida
Seiichiro Hoshino
Naoya Aisu
Ai Mogi
Teppei Yamada
Daibo Kojima
Syu Tanimura
Keiji Hirata
Yuichi Yamashita
Publication date
01-06-2015
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 6/2015
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-014-2518-3

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