Paclitaxel-carboplatin chemotherapy induced hematologic toxicities among epithelial ovarian cancer patients
Abstract: Epithelial ovarian
cancer (EOC) is one of the most common cancers diagnosed in Indonesian women. A
combination of paclitaxel and carboplatin is used to treat EOC as standard
chemotherapy which is known to have hematologic toxicities. This study aimed to
investigate the effect of combined paclitaxel-carboplatin chemotherapy on
hematologic status in EOC patients managed at Dr. Hasan Sadikin General
Hospital, Bandung, West Java.
Methods
All patients with confirmed pathological diagnosis of EOC at Dr. Hasan
Sadikin General Hospital in the period of 2013 to 2014 were registered. Only
patients with complete hematologic data before and after chemotherapy were
collected and compared using the paired non-parametric Wilcoxon and McNemar
tests.
Results
In total there were 147 patients with EOC (median age 46 ± 12 years),
with the most dominant pathological diagnosis of mucinous (32.7%) and serous
(29.3%) types. Only 33 patients had hematologic data before the initiation of
chemotherapy. There was a significant decrease after chemotherapy including
hemoglobin level (12.0 vs 10.9 g/dL, p=0.013), erythrocyte count (4.53 vs 3.74
million/mL, p<0.001), leukocyte count (7,700 vs 4,000/mm3 p<0.001) and
platelet count (343,000 vs 215,000/mm3, p<0.001). Interestingly, anemia
cases after chemotherapy were predominant (87.9%) compared with erythopenia,
leukopenia, thrombocytopenia i.e. 39.4%, 57.6%, and 27.3% respectively.
Conclusions
This study confirmed the hematologic toxicities after
paclitaxel-carboplatin chemotherapy in EOC patients treated in Hasan Sadikin
General Hospital, West Java. The hemoglobin concentration may serve as
prognostic factor. Further studies directed to other factors such as genetic
factor for polymorphisms may be encouraged to explore the decrease of the
hematologic indices.
Keywords: Anemia;
erythropenia; leukopenia; thrombocytopenia; epithelial ovarian cancer;
paclitaxel-carboplatin
Author: Afandi Charles,
Birgitta M. Dewayani, Edhyana Sahiratmadja, Gatot N.A. Winarno, Herman Susanto
Journal Code: jpkedokterangg160190
