Medium adsorbance fraction of reticulocyte and myeloperoxidase index may individuate a patient subset with a low risk of chemotherapy-related neutropenia.
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.
Giordano
Giulio
G
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
Ferrucci
Pier Francesco
PF
Nicci
Chiara
C
Grafone
Tiziana
T
Tambaro
Rosa
R
Papini
Stefano
S
Farina
Giuliana
G
Piano
Silvia
S
Zappacosta
Bruno
B
Storti
Sergio
S
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
D000970:Antineoplastic Agents; D009195:Peroxidase