Chemotherapy-induced thrombocytopenia (CIT, platelet [PLT] count ≤ 100,000/μL after chemotherapy) is a common side effect with an incidence ranging from 16.5% to 21.8% in the global population, but higher than 30% in the patients treated with platinum- or gemcitabine-based regimens. Its treatment is an unmet need and several agents have been studied with unsatisfactory results. Corticosteroids (CSs) are commonly used, even if low evidence is available. The present study aims to observe whether CSs have a positive impact on the outcome of CIT.
We retrospectively reviewed all the cases of patients (affected by thoracic malignancies) experiencing thrombocytopenia after chemotherapy administration at our centre from 2015 to 2021. We excluded all those cases in which it might have been caused by other causes, such as concurrent radiotherapy, extensive bone marrow involvement, the recent introduction of other thrombocytopenia-inducing treatments (such as antibiotics), and the development of immune thrombocytopenia (ITP). We analysed whether patients received CSs or not, identifying two groups (CS-treated vs non-CS-treated), and observed the median duration of CIT in the two subgroups, comparing them with the unpaired t-test. We also focused on the smaller group of patients affected by severe CIT (PLT count ≤ 50,000/μL) and made the same comparison.
174 patients experienced any-grade CIT and were eligible for the analysis. 132 (75.9%) patients experienced mild-to-moderate CIT, whereas 42 (24.1%) experienced severe CIT. 82 (47.1%) patients received CSs, mainly methylprednisolone or dexamethasone. The mean duration of CIT was 5.12 (SD 4.16) days in the CS-treated group and 6.95 (SD 6.6) in the non-CS-treated group (p = 0.03). Considering only the cases of severe CIT, 32 (76.2%) received CSs and 10 (23.8%) did not. The mean duration of severe CIT was 6.78 (SD 5.66) days and 7 (SD 3.13) in the CS-treated and non-CS-treated group, respectively (p = 0.91).
With the limit of a retrospective evaluation, we observed that CSs might have a benefit in mild-to-moderate CIT, whereas they seem to be ineffective in case of severe CIT. Our data should be validated in ad hoc prospective trials to better determine the real impact of CSs on CIT.
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Has not received any funding.
All authors have declared no conflicts of interest.