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Use of Cardioprotective Dexrazoxane Is Associated with Increased Myelotoxicity in Anthracycline-Treated Soft-Tissue Sarcoma Patients
- Publication Year :
- 2019
- Publisher :
- S. Karger AG, 2019.
-
Abstract
- Background: Dexrazoxane (DEX) is indicated as a cardioprotective agent for breast cancer patients receiving the anthracycline doxorubicin. Two meta-analyses in metastatic breast cancer reported an apparent increase in the severity of myelosuppression when DEX was used. So far, no data in soft-tissue sarcoma (STS) patients are available. Methods: We retrospectively analyzed hematological toxicity data from 133 consecutive STS patients who received a chemotherapy regimen containing an anthracycline and ifosfamide (AI) in the perioperative or metastatic settings between January 2006 and December 2017. Of these, 46 received off-label DEX concurrently with the AI treatment. The differences between incidence of any of the explored outcomes were assessed according to the Fisher exact test. Results: Compared with the non-DEX group, DEX treatment was associated with significantly higher rates of grade 3/4 hematological toxicities: leukopenia (56.5 vs. 28.7%; p = 0.0014), neutropenia (69.6 vs. 24.1%; p = 0.0001), febrile neutropenia (52.2 vs. 20.7%; p = 0.0004), anemia (41.3 vs. 28.7%; p = 0.1758), and thrombocytopenia (54.3 vs. 32.1%; p = 0.0159). Similarly, in the DEX group dose reductions were more frequent compared to the non-DEX group (39.1 vs. 19.5%; p = 0.0221). Conclusion: Adding DEX to AI in STS patients leads to higher rates of bone marrow suppression in all blood components, as well as to more frequent events of febrile neutropenia and dose reductions.
- Subjects :
- 0301 basic medicine
Male
Anthracycline
Gastroenterology
0302 clinical medicine
Myelotoxicity
Retrospective Studie
Drug Discovery
Medicine
Pharmacology (medical)
Anthracyclines
Soft tissue sarcoma
Leukopenia
Ifosfamide
Antibiotics, Antineoplastic
Sarcoma
General Medicine
Middle Aged
Chemotherapy regimen
Infectious Diseases
Oncology
Bone marrow suppression
030220 oncology & carcinogenesis
Female
medicine.symptom
medicine.drug
Human
Adult
medicine.medical_specialty
Neutropenia
030106 microbiology
Protective Agents
03 medical and health sciences
Young Adult
Internal medicine
Humans
Dexrazoxane
Protective Agent
Retrospective Studies
Aged
Pharmacology
business.industry
Hematologic Disease
medicine.disease
Hematologic Diseases
business
Febrile neutropenia
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....cd2ebee890abdab2dfac8a0212addf83