title: Skin toxicity as a risk factor for major infections in breast cancer patients treated with docetaxel.
abstract: Docetaxel-related skin toxicity, oral and gastrointestinal mucosal toxicity, and changes in blood cell counts were investigated as predictive factors for major infections in 143 women treated with 3-weekly docetaxel (100 mg/m2) as second-line therapy for metastatic breast cancer in a randomized trial. Each patient with a major infection (n = 37) was compared with two controls. Skin toxicity (odds ratio 2.97, 95% CI 1.37-6.47), oral mucositis (1.98, CI 1.30-3.04), and the leukocyte nadir (0.12, CI 0.02-0.51) were significantly associated with a major infection in a univariate logistic regression analysis. In a multivariate analysis, skin toxicity was the only independent factor predictive for grade 3 to 4 infection (2.75, CI 1.00-7.58). A major infection was diagnosed in 62% (8 out of 13) of the docetaxel cycles in severely (grade 4) leukopenic patients who had grade 2 to 4 skin toxicity. Major infections are common in leukopenic patients who develop docetaxel-associated skin toxicity, and leukopenic patients presenting with docetaxel-induced skin toxicity may be candidates for prophylactic anti-infection measures such as prophylactic therapy with hematopoietic growth factors.
authors.affiliation: Department of Oncology, Helsinki University Central Hospital, Finland. paula.poikonen@hus.fi
authors.forename: Paula
authors.initials: P
authors.lastname: Poikonen
authors.forename: Johanna
authors.initials: J
authors.lastname: Sjöström
authors.forename: Sigrid
authors.initials: S
authors.lastname: Klaar
authors.forename: Lena Tennvall
authors.initials: LT
authors.lastname: Nittby
authors.forename: Helgi
authors.initials: H
authors.lastname: Sigurdsson
authors.forename: Ebbe Lindegaard
authors.initials: EL
authors.lastname: Madsen
authors.forename: Heikki
authors.initials: H
authors.lastname: Joensuu
authors.forename: Carl
authors.initials: C
authors.lastname: Blomqvist
mesh_terms: D000328:Adult; D000368:Aged; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy*; D017326:Clinical Trials, Phase III as Topic; D000077143:Docetaxel; D005260:Female; D006801:Humans; D007239:Infections / Q000209:etiology*; D007958:Leukocyte Count; D008875:Middle Aged; D009061:Mouth Mucosa / Q000187:drug effects; D009092:Mucous Membrane; D009503:Neutropenia / Q000139:chemically induced; D012044:Regression Analysis; D012867:Skin / Q000187:drug effects*; D043823:Taxoids / Q000009:adverse effects*
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D043823:Taxoids; D000077143:Docetaxel