1570P - Chemotherapy-induced thrombocytopenia and clinical bleeding in patients with gynecologic malignancy

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Complications of Treatment
Gynaecologic Malignancies
Presenter Yasunori Hashiguchi
Authors Y. Hashiguchi
  • Obstetrics And Gynecology, Osaka City University, Graduate school of Medicine, 545-8585 - Osaka/JP

Abstract

Objectives

Chemotherapy-induced thrombocytopenia seemed to be a relevant problem in clinical practice. In this study, we investigated chemotherapy-induced thrombocytopenia recently performed in patients with gynecologic malignancy.

Methods

Between January 2009 and December 2011, we examined our reported chemotherapy-induced thrombocytopenia using the Common Terminology Criteria for Adverse Events (CTCAE) v.4.0. We analyzed the incidence and clinical features of chemotherapy-induced thrombocytopenia (≧grade3: platelet count <50,000 /&mgr;L) in patients with gynecologic malignancy.

Results

During this period we administered over 1614 infusions (29 regimens) to 291 patients with gynecologic malignancy. Median age was 60 years (24-84). Thrombocytopenia occurred in 43 (14.8%) patients over 56 (3.5%) chemotherapy cycles. Clinical bleeding occurred in 13 (4.5%) patients over 14 (0.9%) cycles. Major bleeding occurred in 7 (1.3%) cycles (gastrointestinal bleeding: 4, genital bleeding: 2, bladder bleeding: 1). Platelet transfusions were administered for 8 cycles. No life-threatening bleeding occurred in any patient. Thrombocytopenia was associated with more than five previous chemotherapy cycle (p = 0.03), previous radiotherapy (p = 0.0001), disseminated disease (p = 0.006), distant metastatic disease (p = 0.02) and poor performance status (p = 0.0001). Clinical bleeding was associated with previous radiotherapy (p = 0.003), distant metastatic disease (p = 0.03) and poor performance status (p = 0.02). Both clinical bleeding were not related with age, bone marrow metastases or platinum-based regimens. Febrile neutropenia was complicated with 35% of thrombocytopenia cycles and 43% of clinical bleeding cycles.

Conclusions

By estimating risk factor of clinical bleeding such as progression of disease and poor bone marrow reserve, safe management of chemotherapy-induced thrombocytopenia without unnecessary platelet transfusion may be possible in patients with gynecologic malignancy.

Disclosure

All authors have declared no conflicts of interest.