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Chemotherapy-Induced Myelosuppression in Esophageal Cancer Patients: Risks and Suggestions for Its Management

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Summary

Objective

The influential factors of chemotherapy-induced myelosuppression in esophageal cancer in central China are unclear. This study aimed to investigate the effect of commonly used chemotherapy regimens on the incidence of myelosuppression in clinical treatment of esophageal cancer.

Methods

In this retrospective study, 624 patients with esophageal cancer who received six different chemotherapy regimens between 2013 and 2020 at our institute were included. Chemotherapy consisted of lobaplatin, 5-fluorouracil (5-F), lobaplatin and 5-F, nedaplatin, nedaplatin and paclitaxel (PTX), cisplatin and PTX. Multivariable logistic regression analysis was used to explore the risk of myelosuppression among the six different chemotherapy regimens.

Results

Compared with lobaplatin group, the incidence of myelosuppression in patients treated with chemotherapy regimens of lobaplatin and 5-F, nedaplatin, nedaplatin and PTX and cisplatin and PTX were significantly ameliorated. The dose of lobaplatin was significantly reduced (P=0.007) when lobaplatin was combined with 5-F, and the combination could significantly reduce the risk of myelosuppression (P=0.022). Furthermore, chemotherapeutic regimens, the dose of platinum, hemoglobin and uric acid levels, age, sex, total bilirubin and immune-enhancing drugs were found to be strong predictors of developing myelosuppression.

Conclusion

Targeted preventive interventions that enhance immune function, reduce uric acid levels and choose combined medication during chemotherapy should be implemented for high-risk patients to reduce the occurrence of myelosuppression. In addition, the dose of lobaplatin should be adjusted when combined with other chemotherapy drugs to reduce the incidence of myelosuppression.

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Author notes

  1. The authors contributed equally to this work.

Authors and Affiliations

  1. Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China

    Qi-lin Zhang, Ting-ting Wu, Yong Han, Zi-ming Zheng & Yu Zhang

  2. Hubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan, 430030, China

    Qi-lin Zhang, Ting-ting Wu, Yong Han, Zi-ming Zheng & Yu Zhang

Authors
  1. Qi-lin Zhang
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  2. Ting-ting Wu
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  4. Zi-ming Zheng
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  5. Yu Zhang
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Corresponding authors

Correspondence to Zi-ming Zheng or Yu Zhang.

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Conflict of Interest Statement

The authors declare no conflicts of interest.

The present research was supported by a grant from the National Key R&D Programmes (NKPs) of China (No. 2017YFC0909900).

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Zhang, Ql., Wu, Tt., Han, Y. et al. Chemotherapy-Induced Myelosuppression in Esophageal Cancer Patients: Risks and Suggestions for Its Management. CURR MED SCI 42, 530–537 (2022). https://doi.org/10.1007/s11596-022-2587-3

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  • DOI: https://doi.org/10.1007/s11596-022-2587-3

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