title: Medium adsorbance fraction of reticulocyte and myeloperoxidase index may individuate a patient subset with a low risk of chemotherapy-related neutropenia.
abstract: In neoplastic patients chemotherapy frequently involves severe myeloid suppression. Sometimes myeloid suppression is the main cause of therapy recycling delay with severe and prolonged neutropenia, anaemia and thrombocytopenia. Our study aimed to verify whether there is a correlation between reticulocyte fractions, reticulocyte indices, myeloperoxidase index (MPXI) and post-chemotherapy myelopoietic function and severe post-chemotherapy neutropenia. A cohort of 112 patients was identified, 30 with lymphoma or myeloma and 82 with solid neoplasms with bone marrow micrometastases. The patients were treated with chemotherapy (CT). After CT, 60 patients had neutropenia (ANC <500/mcl) for a median of 7 days (range 3-21). Before CT, myelopoietic function was assessed by the above-mentioned parameters using a hematologic automated analyzer. We assigned patients with an MPXI-positive value and medium adsorbance fraction of reticulocyte (MFR) >10.7% a score of 1, and a score of 0 was assigned to the remaining patients. Patients with a score of 1 showed a lower number of neutropenic events (only 9 out of 36 patients) than those with a score of 0 (51 out of 76 patients), p<0.0001. MPXI and MFR may be used in the assessment of myelopoiesis before CT administration, independently of the type of tumor, CT regimen and number of CT cycle, with the aim of identifying a patient subset with a lower risk of developing neutropenia post-CT.
authors.affiliation: Onco-Haematology Division, Centre for High Technology Research and Education in Biomedical Sciences 'John Paul II', Catholic University, 86100 Campobasso, Italy. giulio.giordano@rm.unicatt.it
authors.forename: Giulio
authors.initials: G
authors.lastname: Giordano
authors.forename: Pier Francesco
authors.initials: PF
authors.lastname: Ferrucci
authors.forename: Chiara
authors.initials: C
authors.lastname: Nicci
authors.forename: Tiziana
authors.initials: T
authors.lastname: Grafone
authors.forename: Rosa
authors.initials: R
authors.lastname: Tambaro
authors.forename: Stefano
authors.initials: S
authors.lastname: Papini
authors.forename: Giuliana
authors.initials: G
authors.lastname: Farina
authors.forename: Silvia
authors.initials: S
authors.lastname: Piano
authors.forename: Bruno
authors.initials: B
authors.lastname: Zappacosta
authors.forename: Sergio
authors.initials: S
authors.lastname: Storti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects*; D005260:Female; D005434:Flow Cytometry; D006403:Hematologic Tests / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D038042:Myelopoiesis / Q000187:drug effects*; D009503:Neutropenia / Q000139:chemically induced / Q000175:diagnosis*; D009195:Peroxidase / Q000187:drug effects* / Q000378:metabolism; D011237:Predictive Value of Tests; D012156:Reticulocytes / Q000187:drug effects* / Q000473:pathology; D012307:Risk Factors
chemical_list: D000970:Antineoplastic Agents; D009195:Peroxidase