Sex-Dependent Analysis of Temozolomide-Induced Myelosuppression and Effects on Survival in a Large Real-life Cohort of Patients With Glioma.

Antineoplastic Agents, Alkylating / adverse effects Brain Neoplasms / pathology Female Glioma / pathology Humans Male Retrospective Studies Temozolomide / adverse effects Thrombocytopenia / chemically induced

Journal

Neurology
ISSN: 1526-632X
Titre abrégé: Neurology
Pays: United States
ID NLM: 0401060

Informations de publication

Date de publication:
17 05 2022
Historique:
received: 11 08 2021
accepted: 04 02 2022
pubmed: 31 3 2022
medline: 20 5 2022
entrez: 30 3 2022
Statut: ppublish

Résumé

To investigate the association of radiochemotherapy-induced cytopenia with sex and its potential effect on survival in patients with glioma. We retrospectively analyzed cytopenia during temozolomide-based concomitant radiochemotherapy in 492 patients with glioma. Histologic grading, molecular pathology, surgical procedures, adjuvant chemotherapy subsequent to the radiochemotherapy phase, and overall survival (OS) were recorded. The extent of cytopenia was correlated with sex and outcome. Treatment-induced severe cytopenia (leukocytopenia, lymphocytopenia, neutropenia, and thrombocytopenia) was more frequent in women than men (44 vs 18%; Our analysis of treatment-induced cytopenia in a large cohort of patients with glioma confirms that women are at higher risk and demonstrates an association of cytopenia with shortened survival in women. This study provides Class II evidence that women with glioma treated with temozolomide-based concomitant radiochemotherapy have more frequent treatment-induced severe cytopenia than men and that severe myelosuppression correlates with worse OS in women.

Sections du résumé

BACKGROUND AND OBJECTIVE
To investigate the association of radiochemotherapy-induced cytopenia with sex and its potential effect on survival in patients with glioma.
METHODS
We retrospectively analyzed cytopenia during temozolomide-based concomitant radiochemotherapy in 492 patients with glioma. Histologic grading, molecular pathology, surgical procedures, adjuvant chemotherapy subsequent to the radiochemotherapy phase, and overall survival (OS) were recorded. The extent of cytopenia was correlated with sex and outcome.
RESULTS
Treatment-induced severe cytopenia (leukocytopenia, lymphocytopenia, neutropenia, and thrombocytopenia) was more frequent in women than men (44 vs 18%;
DISCUSSION
Our analysis of treatment-induced cytopenia in a large cohort of patients with glioma confirms that women are at higher risk and demonstrates an association of cytopenia with shortened survival in women.
CLASSIFICATION OF EVIDENCE
This study provides Class II evidence that women with glioma treated with temozolomide-based concomitant radiochemotherapy have more frequent treatment-induced severe cytopenia than men and that severe myelosuppression correlates with worse OS in women.

Identifiants

DOI: 10.1212/WNL.0000000000200254 PMID: 35351796
pubmed: 35351796
pii: WNL.0000000000200254
doi: 10.1212/WNL.0000000000200254
doi:

Substances chimiques

Antineoplastic Agents, Alkylating 0
Temozolomide YF1K15M17Y

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e2073-e2083

Informations de copyright

© 2022 American Academy of Neurology.

Auteurs

Pia S Zeiner (PS)

From the Dr. Senckenberg Institute of Neurooncology (P.S.Z., M.V., J.P.S., M.W.R.), University Cancer Center (UCT) Frankfurt (P.S.Z., K.F., M.V., E.F., P.N.H., J.P.S., M.W.R.), Frankfurt Cancer Institute (FCI) (P.S.Z., K.F., M.V., E.F., P.N.H., J.P.S., M.W.R.), Institute of Neurology (Edinger-Institute) (K.F., P.N.H.), Institute of Biostatistics and Mathematical Modeling (N.F.), Department of Neurosurgery (M.-T.F.), and Department of Radiotherapy and Oncology (E.F.), University Hospital Frankfurt, Goethe University; German Cancer Consortium (DKTK) (P.S.Z., K.F., M.V., E.F., P.N.H., J.P.S., M.W.R.), Frankfurt am Main; and Division of Clinical Neurooncology, Department of Neurology and Centre of Integrated Oncology (U.H.), University Hospital Bonn, Germany.
ORCID: 0000-0001-6626-9211

Katharina Filipski (K)

From the Dr. Senckenberg Institute of Neurooncology (P.S.Z., M.V., J.P.S., M.W.R.), University Cancer Center (UCT) Frankfurt (P.S.Z., K.F., M.V., E.F., P.N.H., J.P.S., M.W.R.), Frankfurt Cancer Institute (FCI) (P.S.Z., K.F., M.V., E.F., P.N.H., J.P.S., M.W.R.), Institute of Neurology (Edinger-Institute) (K.F., P.N.H.), Institute of Biostatistics and Mathematical Modeling (N.F.), Department of Neurosurgery (M.-T.F.), and Department of Radiotherapy and Oncology (E.F.), University Hospital Frankfurt, Goethe University; German Cancer Consortium (DKTK) (P.S.Z., K.F., M.V., E.F., P.N.H., J.P.S., M.W.R.), Frankfurt am Main; and Division of Clinical Neurooncology, Department of Neurology and Centre of Integrated Oncology (U.H.), University Hospital Bonn, Germany.
ORCID: 0000-0001-9395-8944

Natalie Filmann (N)

From the Dr. Senckenberg Institute of Neurooncology (P.S.Z., M.V., J.P.S., M.W.R.), University Cancer Center (UCT) Frankfurt (P.S.Z., K.F., M.V., E.F., P.N.H., J.P.S., M.W.R.), Frankfurt Cancer Institute (FCI) (P.S.Z., K.F., M.V., E.F., P.N.H., J.P.S., M.W.R.), Institute of Neurology (Edinger-Institute) (K.F., P.N.H.), Institute of Biostatistics and Mathematical Modeling (N.F.), Department of Neurosurgery (M.-T.F.), and Department of Radiotherapy and Oncology (E.F.), University Hospital Frankfurt, Goethe University; German Cancer Consortium (DKTK) (P.S.Z., K.F., M.V., E.F., P.N.H., J.P.S., M.W.R.), Frankfurt am Main; and Division of Clinical Neurooncology, Department of Neurology and Centre of Integrated Oncology (U.H.), University Hospital Bonn, Germany.

Marie-Thérèse Forster (MT)

From the Dr. Senckenberg Institute of Neurooncology (P.S.Z., M.V., J.P.S., M.W.R.), University Cancer Center (UCT) Frankfurt (P.S.Z., K.F., M.V., E.F., P.N.H., J.P.S., M.W.R.), Frankfurt Cancer Institute (FCI) (P.S.Z., K.F., M.V., E.F., P.N.H., J.P.S., M.W.R.), Institute of Neurology (Edinger-Institute) (K.F., P.N.H.), Institute of Biostatistics and Mathematical Modeling (N.F.), Department of Neurosurgery (M.-T.F.), and Department of Radiotherapy and Oncology (E.F.), University Hospital Frankfurt, Goethe University; German Cancer Consortium (DKTK) (P.S.Z., K.F., M.V., E.F., P.N.H., J.P.S., M.W.R.), Frankfurt am Main; and Division of Clinical Neurooncology, Department of Neurology and Centre of Integrated Oncology (U.H.), University Hospital Bonn, Germany.

Martin Voss (M)

From the Dr. Senckenberg Institute of Neurooncology (P.S.Z., M.V., J.P.S., M.W.R.), University Cancer Center (UCT) Frankfurt (P.S.Z., K.F., M.V., E.F., P.N.H., J.P.S., M.W.R.), Frankfurt Cancer Institute (FCI) (P.S.Z., K.F., M.V., E.F., P.N.H., J.P.S., M.W.R.), Institute of Neurology (Edinger-Institute) (K.F., P.N.H.), Institute of Biostatistics and Mathematical Modeling (N.F.), Department of Neurosurgery (M.-T.F.), and Department of Radiotherapy and Oncology (E.F.), University Hospital Frankfurt, Goethe University; German Cancer Consortium (DKTK) (P.S.Z., K.F., M.V., E.F., P.N.H., J.P.S., M.W.R.), Frankfurt am Main; and Division of Clinical Neurooncology, Department of Neurology and Centre of Integrated Oncology (U.H.), University Hospital Bonn, Germany.

Emmanouil Fokas (E)

From the Dr. Senckenberg Institute of Neurooncology (P.S.Z., M.V., J.P.S., M.W.R.), University Cancer Center (UCT) Frankfurt (P.S.Z., K.F., M.V., E.F., P.N.H., J.P.S., M.W.R.), Frankfurt Cancer Institute (FCI) (P.S.Z., K.F., M.V., E.F., P.N.H., J.P.S., M.W.R.), Institute of Neurology (Edinger-Institute) (K.F., P.N.H.), Institute of Biostatistics and Mathematical Modeling (N.F.), Department of Neurosurgery (M.-T.F.), and Department of Radiotherapy and Oncology (E.F.), University Hospital Frankfurt, Goethe University; German Cancer Consortium (DKTK) (P.S.Z., K.F., M.V., E.F., P.N.H., J.P.S., M.W.R.), Frankfurt am Main; and Division of Clinical Neurooncology, Department of Neurology and Centre of Integrated Oncology (U.H.), University Hospital Bonn, Germany.

Ulrich Herrlinger (U)

From the Dr. Senckenberg Institute of Neurooncology (P.S.Z., M.V., J.P.S., M.W.R.), University Cancer Center (UCT) Frankfurt (P.S.Z., K.F., M.V., E.F., P.N.H., J.P.S., M.W.R.), Frankfurt Cancer Institute (FCI) (P.S.Z., K.F., M.V., E.F., P.N.H., J.P.S., M.W.R.), Institute of Neurology (Edinger-Institute) (K.F., P.N.H.), Institute of Biostatistics and Mathematical Modeling (N.F.), Department of Neurosurgery (M.-T.F.), and Department of Radiotherapy and Oncology (E.F.), University Hospital Frankfurt, Goethe University; German Cancer Consortium (DKTK) (P.S.Z., K.F., M.V., E.F., P.N.H., J.P.S., M.W.R.), Frankfurt am Main; and Division of Clinical Neurooncology, Department of Neurology and Centre of Integrated Oncology (U.H.), University Hospital Bonn, Germany.

Patrick N Harter (PN)

From the Dr. Senckenberg Institute of Neurooncology (P.S.Z., M.V., J.P.S., M.W.R.), University Cancer Center (UCT) Frankfurt (P.S.Z., K.F., M.V., E.F., P.N.H., J.P.S., M.W.R.), Frankfurt Cancer Institute (FCI) (P.S.Z., K.F., M.V., E.F., P.N.H., J.P.S., M.W.R.), Institute of Neurology (Edinger-Institute) (K.F., P.N.H.), Institute of Biostatistics and Mathematical Modeling (N.F.), Department of Neurosurgery (M.-T.F.), and Department of Radiotherapy and Oncology (E.F.), University Hospital Frankfurt, Goethe University; German Cancer Consortium (DKTK) (P.S.Z., K.F., M.V., E.F., P.N.H., J.P.S., M.W.R.), Frankfurt am Main; and Division of Clinical Neurooncology, Department of Neurology and Centre of Integrated Oncology (U.H.), University Hospital Bonn, Germany.
ORCID: 0000-0001-5530-6910

Joachim P Steinbach (JP)

From the Dr. Senckenberg Institute of Neurooncology (P.S.Z., M.V., J.P.S., M.W.R.), University Cancer Center (UCT) Frankfurt (P.S.Z., K.F., M.V., E.F., P.N.H., J.P.S., M.W.R.), Frankfurt Cancer Institute (FCI) (P.S.Z., K.F., M.V., E.F., P.N.H., J.P.S., M.W.R.), Institute of Neurology (Edinger-Institute) (K.F., P.N.H.), Institute of Biostatistics and Mathematical Modeling (N.F.), Department of Neurosurgery (M.-T.F.), and Department of Radiotherapy and Oncology (E.F.), University Hospital Frankfurt, Goethe University; German Cancer Consortium (DKTK) (P.S.Z., K.F., M.V., E.F., P.N.H., J.P.S., M.W.R.), Frankfurt am Main; and Division of Clinical Neurooncology, Department of Neurology and Centre of Integrated Oncology (U.H.), University Hospital Bonn, Germany.

Michael W Ronellenfitsch (MW)

From the Dr. Senckenberg Institute of Neurooncology (P.S.Z., M.V., J.P.S., M.W.R.), University Cancer Center (UCT) Frankfurt (P.S.Z., K.F., M.V., E.F., P.N.H., J.P.S., M.W.R.), Frankfurt Cancer Institute (FCI) (P.S.Z., K.F., M.V., E.F., P.N.H., J.P.S., M.W.R.), Institute of Neurology (Edinger-Institute) (K.F., P.N.H.), Institute of Biostatistics and Mathematical Modeling (N.F.), Department of Neurosurgery (M.-T.F.), and Department of Radiotherapy and Oncology (E.F.), University Hospital Frankfurt, Goethe University; German Cancer Consortium (DKTK) (P.S.Z., K.F., M.V., E.F., P.N.H., J.P.S., M.W.R.), Frankfurt am Main; and Division of Clinical Neurooncology, Department of Neurology and Centre of Integrated Oncology (U.H.), University Hospital Bonn, Germany.
ORCID: 0000-0002-1402-6290

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Classifications MeSH

questionsmedicales.fr › Actions chimiques et utilisations › Actions toxiques › Noxas › Agents alcoylants › Antinéoplasiques alcoylants › Sex-Dependent Analysis of Temozolomide-Induced...
questionsmedicales.fr › Maladies du système nerveux › Tumeurs du système nerveux › Tumeurs du système nerveux central › Tumeurs du cerveau › Sex-Dependent Analysis of Temozolomide-Induced...
questionsmedicales.fr › Tumeurs › Tumeurs par type histologique › Tumeurs du tissu nerveux › Tumeurs neuroectodermiques › Tumeurs neuroépitheliales › Gliome › Sex-Dependent Analysis of Temozolomide-Induced...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Sex-Dependent Analysis of Temozolomide-Induced...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Sex-Dependent Analysis of Temozolomide-Induced...
questionsmedicales.fr › Composés hétérocycliques › Composés hétéromonocycliques › Azoles › Imidazoles › Dacarbazine › Témozolomide › Sex-Dependent Analysis of Temozolomide-Induced...
questionsmedicales.fr › Hémopathies et maladies lymphatiques › Hémopathies › Anomalies des plaquettes › Thrombopénie › Sex-Dependent Analysis of Temozolomide-Induced...