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01-04-2018 | Original Article

Prognostic importance of temozolomide-induced neutropenia in glioblastoma, IDH-wildtype patients

Authors: Taiichi Saito, Kazuhiko Sugiyama, Seiji Hama, Fumiyuki Yamasaki, Takeshi Takayasu, Ryo Nosaka, Yoshihiro Muragaki, Takakazu Kawamata, Kaoru Kurisu

Published in: Neurosurgical Review | Issue 2/2018

Abstract

Standard treatment for patients with primary glioblastoma (GBM) includes surgery, radiotherapy, and concomitant and adjuvant temozolomide (TMZ). Recent reports have demonstrated that TMZ-induced myelosuppression correlates with survival in patients with GBM. However, those results were evaluated before the 2016 revision of the World Health Organization classification. This study examined whether myelosuppression during concomitant TMZ phase correlates with prognosis in GBM, IDH-wildtype patients. We examined circulating blood cell counts in 50 patients with GBM, IDH-wildtype who received the standard treatment protocol between August 2005 and November 2015. We assessed relationships between rates of decrease in blood cells (white blood cells (WBC), neutrophils, lymphocytes, red blood cells, and platelets) during the concomitant TMZ phase and overall survival (OS) using univariate and multivariate analyses including other clinicopathological factors (age, sex, Karnofsky Performance Status (KPS), extent of resection, O⁶-methylguanine-DNA methyltransferase (MGMT) status). Log-rank testing revealed that age, KPS, extent of resection, MGMT status, and decrease rates of WBC, neutrophils, and platelets correlated significantly with OS. On multivariate analysis, age, MGMT status, and decrease rate of neutrophils correlated significantly with OS. Patients with a ≥ 40% decrease in neutrophils showed significantly longer OS than those with < 40% (hazard ratio = 2.815; 95% confidence interval = 1.177–7.038; P = 0.0196). A decrease of ≥ 40% in neutrophils represents a predictor of good prognosis for GBM, IDH-wildtype. Blood cell counts during the concomitant TMZ phase can help predict OS in patients with GBM, IDH-wildtype receiving the standard treatment protocol.

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Title: Prognostic importance of temozolomide-induced neutropenia in glioblastoma, IDH-wildtype patients
Authors: Taiichi Saito
Kazuhiko Sugiyama
Seiji Hama
Fumiyuki Yamasaki
Takeshi Takayasu
Ryo Nosaka
Yoshihiro Muragaki
Takakazu Kawamata
Kaoru Kurisu
Publication date: 01-04-2018
Publisher: Springer Berlin Heidelberg
Published in: Neurosurgical Review / Issue 2/2018
Print ISSN: 0344-5607
Electronic ISSN: 1437-2320
DOI: https://doi.org/10.1007/s10143-017-0903-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Prognostic importance of temozolomide-induced neutropenia in glioblastoma, IDH-wildtype patients

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

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