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/Toxicities of Treatment
Gynaecological Malignancies
Therapy
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.