Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
권호 표지
DOI QR코드

DOI QR Code

Predictive Value of Baseline Plasma D-dimers for Chemotherapy-induced Thrombocytopenia in Patients with Stage III Colon Cancer: A Pilot Study

  • Tanriverdi, Ozgur (Department of Medical Oncology, Mugla Sitki Kocman University Education and Research Hospital)
  • Published : 2013.01.31
Download PDF
⟨ Previous Next ⟩

Abstract

Background: : Chemotherapy-induced thrombocytopenia (CIT) is an important cause of morbitity in patients with cancer. Aim: To investigate the effect of the baseline plasma D-dimer level, an important marker for thrombotic activity, on chemotherapy-induced thrombocytopenia in patients with stage III colon cancer. Materials and Methods: A total of 43 (28 men) eligible patients were divided into two groups according to whether they exhibited chemotherapy-induced thrombocytopenia: Group 1 (n=21) and Group 2 (n=22). Comparison was made using demographic, histopathologic, and laboratory variables. Additionally, baseline plasma D-dimer levels underwent receiver operation characteristics curve analysis, and areas under the curve were calculated. Sensitivity, specificity, and positive and negative likelihood rates were then determined. Results: The incidence of chemotherapy-induced thrombocytopenia had a significant correlation with baseline platelet count (r=0.568, P=0.031) and baseline plasma D-dimer levels (r=0.617, P=0.036). When the cut-off point for the latter was set as 498 ng/mL, the area under the curve was 0.89 (95%CI: 0.74-0.93), the sensitivity was 91.4%, the specificity was 89.7%, the positive likelihood rate was 3.64 and the negative likelihood rate was 0.24 for chemotherapy-induced thrombocytopenia diagnosis. Conclusions: The baseline level of plasma D-dimer could help to differentiate high-risk patients for chemotherapy-induced thrombocytopenia.

Keywords

References

  1. Antoniou D, Pavlakou G, Stathopoulos GP, et al (2006). Predictive value of D-dimer plasma levels in response and progressive disease in patients with lung cancer. Lung Cancer, 53, 205-10. https://doi.org/10.1016/j.lungcan.2006.03.015
  2. Arnold DM, Lim W (2011). A rational approach to the diagnosis and management of thrombocytopenia in the hospitalized patient. Semin Hematol, 48, 251-8. https://doi.org/10.1053/j.seminhematol.2011.08.002
  3. Andre T, Boni C, Mounedji-Boudiaf L (2004). Oxaliplatin, fluorouracil, and leucovorin an adjuvant treatment for colon cancer. N Engl J Med, 350, 2343-52. https://doi.org/10.1056/NEJMoa032709
  4. Bartucci M, Dattilo R, Martinetti D, et al (2011). Prevention of chemotherapy-induced anemia and thrombocytopenia by constant administration of stem cell factor. Clin Cancer Res, 17, 6185-91. https://doi.org/10.1158/1078-0432.CCR-11-1232
  5. Blackwell K, Haroon Z, Broadwater G, et al (2000). Plasma D-dimer levels in operable breast cancer patients correlate with clinical stage and axillary lymph node status. J Clin Oncol, 18, 600-8.
  6. Colucci G, Gebbia V, Paoletti G, et al (2005). Phase III randomized trial of FOLFIRI versus FOLFOX4 in the treatment of advanced colorectal cancer: a multicenter study of the gruppo oncologica dell'italia meridionale. J Clin Oncol, 23, 4866-75. https://doi.org/10.1200/JCO.2005.07.113
  7. Dirix LY, Salgado R, Weytjens R, et al (2002). Plasma fibrin D-dimer levels correlate with tumour volume, progression rate and survival in patients with metastatic breast cancer. Br J Cancer, 86, 389-95. https://doi.org/10.1038/sj.bjc.6600069
  8. Edwards CM, Warren J, Armstrong L, Donnelly PK (1993). D-dimer: a useful marker of disease stage in surgery for colorectal cancer. Br J Surg, 80, 1404-5. https://doi.org/10.1002/bjs.1800801116
  9. Hitron A, Steinke D, Sutphin S, et al (2011). Incidence and risk factors of clinically significant chemotherapy-induced thrombocytopenia in patients with solid tumors. J Oncol Pharm Pract, 17, 312-9. https://doi.org/10.1177/1078155210380293
  10. Jelic S, Radulovic S (2006). Chemotherapy-associated thrombocytopenia: current and emerging management strategies. Am J Cancer, 6, 372-82.
  11. Kirwan CC, McDowell G, McCollum CN, Kumar S, Byrne GJ (2008). Early changes in the haemostatic and procoagulant systems after chemotherapy for breast cancer. Br J Cancer, 99, 1000-6. https://doi.org/10.1038/sj.bjc.6604620
  12. Komurcuoglu B, Ulusoy S, Gayaf M, et al (2011). Prognostic value of plasma D-dimer levels in lung carcinoma. Tumori, 97, 743-8.
  13. Levin RD, Daehler MA, Grutsch JF, et al (2010). Dose escalation study of an anti-thrombocytopenic agent in patients with chemotherapy induced thrombocytopenia. BMC Cancer, 10, 565-72. https://doi.org/10.1186/1471-2407-10-565
  14. Oya M, Akiyama Y, Okuyama T, Ishikawa H (2001). High preoperative plasma D-dimer level is associated with advanced tumor stage and short survival after curative resection in patients with colorectal cancer. Jpn J Clin Oncol, 31, 388-94. https://doi.org/10.1093/jjco/hye075
  15. Sekhon SS, Roy V (2006). Thrombocytopenia in adults: a practical approach to evaluation and management. South Med J, 99, 491-8. https://doi.org/10.1097/01.smj.0000209275.75045.d4
  16. Ten Berg MJ, van den Bent PM, Shantakumar S, et al (2011). Thrombocytopenia in adult cancer patients receiving cytotoxic chemotherapy: results from a retrospective hospital-based cohort study. Drug Saf, 34, 1151-60. https://doi.org/10.2165/11594310-000000000-00000
  17. Wu S, Zhang Y, Xu L, et al (2012). Multicenter, randomized study of genetically modified recombinant human interleukin-11 to prevent chemotherapy-induced thrombocytopenia in cancer patients receiving chemotherapy. Support Care Cancer, 20, 1875-84 https://doi.org/10.1007/s00520-011-1290-x
  18. Yamamato M, Yoshinaga K, Matsuyama A, et al (2012). Plasma D-dimer level as a mortality predictor in patients with advanced or recurrent colorectal cancer. Oncology, 83, 10-5. https://doi.org/10.1159/000338329
  19. Yashiki C, Hirose T, Sugiyama T, et al (2010). Chemotherapyinduced myelosuppression and treatment efficacy in limitedstage disease small cell lung cancer. Gan To Kagaku Ryoho, 37, 245-9.

Cited by

  1. Malignancies and Disseminated Intravascular Coagulation vol.14, pp.7, 2013, https://doi.org/10.7314/APJCP.2013.14.7.4459
  2. Is there any effect of lower extremity deep vein thrombosis which proven by Doppler ultrasonography on cancer recurrence in patients with stage III colon cancer? A study of the Turkish Descriptive Oncological Researches Group vol.31, pp.10, 2014, https://doi.org/10.1007/s12032-014-0215-1