title: Urinary neopterin, hemoglobin and peripheral blood cell counts in breast carcinoma patients treated with dose-dense chemotherapy.
abstract: BACKGROUND
  Among other actions, chemotherapy may induce an activation of systemic inflammatory and immune response.
  
  
  METHODS
  Urinary neopterin was evaluated, using high-performance liquid chromatography, before and during dose-dense combination chemotherapy with doxorubicin, cyclophosphamide and sequential paclitaxel (neoadjuvant or adjuvant) in 194 patients with breast carcinoma. Hemoglobin, peripheral blood cell count and, in a subgroup of patients, iron metabolism were also evaluated.
  
  
  RESULTS
  Urinary neopterin increased significantly during the chemotherapy. The increase in urinary neopterin was accompanied by a gradual decrease of hemoglobin. A marked increase in serum ferritin concentration was observed during the chemotherapy, along with fluctuations of iron concentrations. Among 161 patients treated with primary chemotherapy, the pathological response was evaluable in 150. Pathological complete response was observed in 37 cases (25%). In patients with pathological complete response, significantly lower serum ferritin concentrations were observed.
  
  
  CONCLUSIONS
  Present data demonstrate the presence of systemic immune activation, reflected in increased urinary neopterin concentrations, in breast carcinoma patients treated with dose-dense chemotherapy. Lower ferritin concentrations were predictive of pathological complete response.
authors.affiliation: Department of Oncology & Radiotherapy, Charles University Medical School & Teaching Hospital, Czech Republic. bohuslav.melichar@fnol.cz
authors.forename: Bohuslav
authors.initials: B
authors.lastname: Melichar
authors.forename: Lubor
authors.initials: L
authors.lastname: Urbánek
authors.forename: Lenka
authors.initials: L
authors.lastname: Krcmová
authors.forename: Hana
authors.initials: H
authors.lastname: Kalábová
authors.forename: Karolina
authors.initials: K
authors.lastname: Melicharová
authors.forename: Eva
authors.initials: E
authors.lastname: Malírová
authors.forename: Helena
authors.initials: H
authors.lastname: Hornychová
authors.forename: Ales
authors.initials: A
authors.lastname: Ryska
authors.forename: Radomír
authors.initials: R
authors.lastname: Hyspler
authors.forename: Dagmar
authors.initials: D
authors.lastname: Solichová