title: Chemotherapy-related myelosuppression as a marker of survival in epithelial ovarian cancer patients.
abstract: OBJECTIVE
  Authors have suggested that chemotherapy-induced neutropenia could represent a surrogate parameter of cancer stem cell response to treatment. Thus, the aim of this study was to evaluate the association of relative chemotherapy-induced neutropenia with survival in advanced epithelial ovarian cancer (EOC).
  
  
  METHODS
  A computerized database identified patients for primary advanced EOC with 6 cycles of platinum-taxane-based chemotherapy. Data collected included demographics, chemotherapy administration, laboratory evaluation, and survival outcomes. Relative neutropenia, defined as an absolute neutrophil count (ANC) <1000/mm3 at chemotherapy cycle nadir, was evaluated and correlated to PFS, OS, and platinum sensitivity (recurrence >6 months from completion of chemotherapy).
  
  
  RESULTS
  255 patients were identified. Patients with neutropenia (n=203) during treatment were similar to patients who never had neutropenia (n=52) in regards to age, race, body mass index (BMI), stage, histology, grade, and debulking status. Neutropenic patients demonstrated improvements in PFS (14 vs. 6 months; p=0.01), OS (45 vs. 29 months; p=0.03) and platinum sensitivity rates (69% vs. 44%; p=0.001). As the number of neutropenic episodes increased, improvements in PFS (range 6 to 17 months; p=0.07) and platinum sensitivity (range 44% to 90%; p=0.002) was demonstrated. When stratified by debulking status, neutropenia conferred a survival advantage in suboptimally debulked patients, but only demonstrated marginal improvements in optimally debulked patients.
  
  
  CONCLUSIONS
  Our data demonstrates that patients with chemotherapy-induced neutropenia is associated with a survival advantage in ovarian cancer, especially in suboptimally debulked patients.
authors.affiliation: Division of Gynecologic Oncology, University of South Alabama Mitchell Cancer Institute, 1 Mobile Infirmary Circle, 1st Floor, Mobile, AL 36607, USA. rocconi@usouthal.edu
authors.forename: Rodney P
authors.initials: RP
authors.lastname: Rocconi
authors.forename: Kellie S
authors.initials: KS
authors.lastname: Matthews
authors.forename: Meredith K
authors.initials: MK
authors.lastname: Kemper
authors.forename: Kelly E
authors.initials: KE
authors.lastname: Hoskins
authors.forename: Mack N
authors.initials: MN
authors.lastname: Barnes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D014411:Neoplastic Stem Cells / Q000187:drug effects / Q000473:pathology; D009503:Neutropenia / Q000139:chemically induced*; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects; D010051:Ovarian Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D009944:Organoplatinum Compounds; D043823:Taxoids