title: Bevacizumab improves splenomegaly and decreases production of hyaluronic acid after L-OHP based chemotherapy.
abstract: BACKGROUND
  Oxaliplatin-based chemotherapy can cause hepatic sinusoidal injury such as sinusoidal obstructive syndrome (SOS). Spleen size is correlated with sinusoidal damage, and serum hyaluronic acid is also a marker of SOS. The aim of the present study was to clarify the impact of the current chemotherapeutic regimen plus bevacizumab against oxaliplatin-associated hepatic damage with serum hyaluronic acid and spleen size.
  
  
  METHODS
  Sixteen adult patients with colorectal cancer and liver metastasis were evaluated retrospectively. In the bevacizumab-treated group (n=9), oxaliplatin-based chemotherapy with bevacizumab prior to hepatic resection was administered, while oxaliplatin-based chemotherapy-alone was administered prior to hepatic resection in the control group (n=7). Hepatic sinusoidal injury, change in spleen size and serum value of hyaluronic acid were evaluated.
  
  
  RESULTS
  The incidence and severity of sinusoidal dilation was lower in the bevacizumab group than in the control group (moderate or severe: 2/9 (22.2%) vs. 5/7 (71.4%), incidence of sinusoidal dialation: 5/9 (55.6%) vs. 7/7 (100%), both p<0.05). The change in spleen size and serum hyaluronic acid were significantly lower in the bevacizumab-treated group compared to the control group (change in spleen size: 110.3%±27.5% vs. 146.3%±34.2%, hyaluronic acid: 33.6±21.2 ng/ml vs. 124.5±34.0 ng/ml, both p<0.05).
  
  
  CONCLUSIONS
  In the current study, bevacizumab reduced SOS in pathological findings and suppressed the elevation of hyaluronic acid, and splenomegaly. In addition, a change in spleen size and serum hyaluronic acid could serve as a biomarker for a predictive effect of bevacizumab against SOS.
authors.affiliation: Assistant Professor, Institute of Health Biosciences, Department of Surgery, The University of Tokushima Graduate School 3-18-15 Kuramoto, Tokushima 770-8503, Japan. yarakawa@clin.med.tokushima-u.ac.jp.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Arakawa
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Shimada
authors.forename: Tohru
authors.initials: T
authors.lastname: Utsunomiya
authors.forename: Satoru
authors.initials: S
authors.lastname: Imura
authors.forename: Yuji
authors.initials: Y
authors.lastname: Morine
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ikemoto
authors.forename: Jun
authors.initials: J
authors.lastname: Hanaoka
authors.forename: Mami
authors.initials: M
authors.lastname: Kanamoto
authors.forename: Shuichi
authors.initials: S
authors.lastname: Iwahashi
authors.forename: Yu
authors.initials: Y
authors.lastname: Saito
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Yamada
authors.forename: Michihito
authors.initials: M
authors.lastname: Asanoma
authors.forename: Chie
authors.initials: C
authors.lastname: Takasu
authors.forename: Yoshimi
authors.initials: Y
authors.lastname: Bando
mesh_terms: D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D000068258:Bevacizumab; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000473:pathology; D005260:Female; D006504:Hepatic Veno-Occlusive Disease / Q000139:chemically induced* / Q000150:complications*; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood; D015994:Incidence; D008099:Liver / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects*; D000077150:Oxaliplatin; D012189:Retrospective Studies; D013154:Spleen / Q000473:pathology; D013163:Splenomegaly / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D014057:Tomography, X-Ray Computed
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D000068258:Bevacizumab; D006820:Hyaluronic Acid
keywords: Sinusoidal obstruction syndrome; bevacizumab; oxaliplatin