Population analysis of myelosuppression profiles using routine clinical data after the ICE (ifosfamide/carboplatin/etoposide) regimen for malignant gliomas.
We propose a simple and practical modeling approach for analysis of the data for myelosuppression after cancer chemotherapy, which can be applied when pharmacokinetic data are not available and several anticancer drugs were simultaneously administered. The model equation is based on the probability density function for the Erlang distribution. The data for cell counts of leukocytes (white blood cell, WBC), platelets (PLT), and reticulocytes (RET) obtained in routine clinical laboratory tests after the ICE (ifosfamide/carboplatin/etoposide) regimen for cancer chemotherapy were retrospectively collected from 28 patients, and a population analysis was applied. The time course profiles could be well explained by the proposed model. The individual values of the time to reach the nadir were obtained by the Bayesian method, and their medians (days) were 16.8 for WBC, 12.8 for PLT, and 8.2 for RET. Such information would be useful to determine the day of visit for outpatients especially for additional treatment to prevent side effects such as infections. The model is simple and applicable to explain the time course profiles for myelosuppression irrespective of cell types, and also practical because it requires only the data from routine clinical laboratory tests without any additional burden to patients.
Yano
Yoshitaka
Y
Center for Integrative Education of Pharmacy Frontier, Graduate School of Pharmaceutical Sciences, Kyoto University, 46-29 Shimoadachi-cho, Yoshida, Sakyo-ku, Kyoto 606-8501, Japan. yano@pharm.kyoto-u.ac.jp
Kodawara
Takaaki
T
Hongo
Haruyuki
H
Yano
Ikuko
I
Kishi
Yo
Y
Takahashi
Jun
J
Inui
Ken-ichi
K
D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols; D001499:Bayes Theorem; D016190:Carboplatin / Q000627:therapeutic use*; D003198:Computer Simulation; D005047:Etoposide / Q000627:therapeutic use*; D005260:Female; D005910:Glioma / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D007069:Ifosfamide / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007700:Kinetics; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009010:Monte Carlo Method; D009503:Neutropenia / Q000139:chemically induced; D010976:Platelet Count; D017701:Reticulocyte Count; D012189:Retrospective Studies
D000970:Antineoplastic Agents; D018906:Antineoplastic Agents, Alkylating; D000972:Antineoplastic Agents, Phytogenic; D007166:Immunosuppressive Agents; D005047:Etoposide; D016190:Carboplatin; D007069:Ifosfamide