title: Prognostic value of chemotherapy-induced hematological toxicity in metastatic colorectal cancer patients.
abstract: OBJECTIVE
  To establish whether chemotherapy-induced neutropenia is predictive of better outcome in patients with metastatic colorectal cancer (mCRC).
  
  
  METHODS
  Survival and patient characteristics from consecutive mCRC patients treated in the Centre Georges Francois Leclerc, Dijon, France between January 2001 and December 2011 were analyzed. Patient and tumor characteristics, hematological toxicity (neutropenia, anemia, and thrombocytopenia), and type of chemotherapy received were recorded.
  
  
  RESULTS
  We retrospectively analyzed data from 399 consecutive patients with mCRC who received at least one line of chemotherapy. Median follow up was 6.3 years. Eighty-eight percent of the patients received more than two lines of chemotherapy. By univariate analysis, whatever their grade, neutropenia and thrombocytopenia occurring during the first two lines of chemotherapy were significantly associated with better overall survival (HR = 0.55, 95%CI: 0.43-0.70, P < 0.0001 and HR = 0.70, 95%CI: 0.56-0.88, P = 0.025 respectively). In contrast, anemia during chemotherapy was significantly associated with poorer overall survival (HR = 1.9, 95%CI: 1.22-2.97, P = 0.005). Multivariate analysis revealed that both neutropenia and thrombocytopenia were significantly associated with better overall survival: HR = 0.43, 95%CI: 0.29-0.64, P < 0.0001 and HR = 0.69, 95%CI: 0.49-0.98, P = 0.036, respectively.
  
  
  CONCLUSIONS
  These data suggest that occurrence of neutropenia or thrombocytopenia during first- or second-line chemotherapy for mCRC is associated with better survival.
authors.affiliation: Laurie Rambach, Julie Vincent, Veronique Lorgis, Sylvain Ladoire, Francois Ghiringhelli, Department of Medical Oncology, Centre Georges-François Leclerc, 21000 Dijon, France.
authors.forename: Laurie
authors.initials: L
authors.lastname: Rambach
authors.affiliation: Laurie Rambach, Julie Vincent, Veronique Lorgis, Sylvain Ladoire, Francois Ghiringhelli, Department of Medical Oncology, Centre Georges-François Leclerc, 21000 Dijon, France.
authors.forename: Aurelie
authors.initials: A
authors.lastname: Bertaut
authors.affiliation: Laurie Rambach, Julie Vincent, Veronique Lorgis, Sylvain Ladoire, Francois Ghiringhelli, Department of Medical Oncology, Centre Georges-François Leclerc, 21000 Dijon, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Vincent
authors.affiliation: Laurie Rambach, Julie Vincent, Veronique Lorgis, Sylvain Ladoire, Francois Ghiringhelli, Department of Medical Oncology, Centre Georges-François Leclerc, 21000 Dijon, France.
authors.forename: Veronique
authors.initials: V
authors.lastname: Lorgis
authors.affiliation: Laurie Rambach, Julie Vincent, Veronique Lorgis, Sylvain Ladoire, Francois Ghiringhelli, Department of Medical Oncology, Centre Georges-François Leclerc, 21000 Dijon, France.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Ladoire
authors.affiliation: Laurie Rambach, Julie Vincent, Veronique Lorgis, Sylvain Ladoire, Francois Ghiringhelli, Department of Medical Oncology, Centre Georges-François Leclerc, 21000 Dijon, France.
authors.forename: Francois
authors.initials: F
authors.lastname: Ghiringhelli
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002166:Camptothecin / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D015179:Colorectal Neoplasms / Q000150:complications / Q000188:drug therapy*; D016208:Databases, Factual; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D000077146:Irinotecan; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D009503:Neutropenia / Q000139:chemically induced* / Q000150:complications; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects; D000077150:Oxaliplatin; D011379:Prognosis; D012189:Retrospective Studies; D013921:Thrombocytopenia / Q000139:chemically induced / Q000150:complications; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D000077146:Irinotecan; D005472:Fluorouracil; D002166:Camptothecin
keywords: Chemotherapy; Colorectal cancer; Metastasis; Neutropenia; Prognostic factor