Gender Differences in Hematotoxicity Induced by Gemcitabine Monotherapy

Miura, Asako; Onoue, Masahide; Takato, Tsuyoshi; Takahashi, Kunitaro; Inui, Kentaro

doi:10.5649/jjphcs.36.57

Cited by 4 publications

(2 citation statements)

References 3 publications

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“…With regard to the differences in hematotoxicity profile by body composition in patients with pancreatobiliary tract cancer, the current findings indicate that a decreased WBC count was more common in women with a high body fat rate. Similarly, Miura et al (42) have reported that a decreased neutrophil count induced by GEM administration was more common in women. In addition, among the body composition changes associated with surgery in one patient from the present study (Fig.…”

Section: Discussionmentioning

confidence: 99%

Measuring body composition using the bioelectrical impedance method can predict the outcomes of gemcitabine-based chemotherapy in patients with pancreatobiliary tract cancer

et al. 2015

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Abstract. In order to examine the effect on body composition of anticancer drug treatments, the body composition rate in patients being treated with gemcitabine (GEM)-based chemotherapy was measured over time on an outpatient basis with a simple body composition monitor using the bioelectrical impedance (BI) method. The results revealed a significant reduction in the body fat rate (P=0.01) over the course of treatment in patients with pancreatobiliary tract cancer who became unable to continue GEM-based chemotherapy due to progressive disease or a decreased performance status. Meanwhile, no changes were observed in the body composition of control patients with urothelial carcinoma receiving GEM-based chemotherapy. In association with the adverse reactions to GEM and the hematotoxicity profile, a decreased white blood cell count was more likely to occur in body fat-dominant patients (mean fat rate, 25.8%; mean muscle rate, 26.2%), whereas a decreased blood platelet count was more likely to occur in skeletal muscle-dominant patients (mean fat rate, 23.3%; mean muscle rates, 28.7%). The correlation between body composition parameters and the relative dose intensity (RDI) associated with GEM administration was also analyzed. The results revealed a positive correlation between the RDI and basal metabolism amount (P=0.03); however, the RDI did not correlate with the body fat rate, skeletal muscle rate or body mass index (P=0.61, P=0.14 and P=0.20, respectively).In conclusion, the body composition rate measurement using the BI method over time may be useful for predicting the outcome of GEM-based chemotherapy and adverse events in patients with pancreatobiliary tract cancer. In particular, the present findings indicate that the changes in body fat rate may be helpful as an adjunct index for assessing potential continuation of chemotherapy and changes in physical conditions.

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Section: Discussionmentioning

confidence: 99%

Measuring body composition using the bioelectrical impedance method can predict the outcomes of gemcitabine-based chemotherapy in patients with pancreatobiliary tract cancer

et al. 2015

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“…For example, a study showed a significantly higher incidence of decreased white blood cell (WBC) count and neutropenia after receiving the combination of a platinum compound (cisplatin [CDDP] or carboplatin [CBDCA]) and gemcitabine (GEM) in female non-small cell lung cancer patients than in male counterpart 5) . Another study reported a significantly higher incidence of neutropenia after receiving GEM in female pancreatic cancer patients than in male patients 6) . These studies suggest gender differences in the reactivity of blood cells, especially neutrophils (Neut), to drugs.…”

Section: Introductionmentioning

confidence: 95%

Gender Difference in Allergic Reactions and the Fluctuation of Blood Cells Induced by Platinum-based Anticancer Drugs

Arii

Nojima

2020

Juntendo Medical Journal

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Objective: Gender differences in therapeutic and side effects of anticancer drugs have been reported. In our previous study with a small sample size, we reported that female patients are significantly more allergic than male allergic (Alg) patients to oxaliplatin (L-OHP), a platinum-based anticancer drug (platinum compound). On the other hand, there are no studies showing significant gender differences in drug allergy to non-anticancer drugs. And the presence of gender differences in drug allergy to anticancer drugs has not been established. In addition, there are studies showing an increase in peripheral white blood cell (WBC) count after Alg diseases and some drug allergy. However, there have been no studies on fluctuation of WBC count and blood cell fractionation in drug allergy to anticancer drugs. Therefore, in this study, with a larger sample size, we examined gender differences in drug allergy to anticancer drugs and fluctuation of WBC count and blood cell fractionation during Alg reactions. patients who were treated with four platinum compounds were retrospectively analyzed.Methods: Data obtained from the peripheral blood samples collected from each patient was used to determine WBC count.Results: A total of 35 patients were found to be allergic. The overall results for all platinum compounds showed a higher incidence of drug allergy in female patients than in male patients (p = 0.049). The reactions were more pronounced in female patients receiving carboplatin (CBDCA)(p = 0.034). In the Alg group, WBC count after Alg reactions was significantly higher (no statistically) and the percentage of neutrophils significantly increased (p = 0.024), whereas the percentage of monocytes was significantly decreased (p = 0.024). There were no gender differences in the incidence of leukocytosis before Alg reactions.However, the incidence of leukocytosis after Alg reactions was significantly higher in female patients than in male patients (p = 0.031). Additionally, fluctuation in the percentage of blood cells, such as an increase in neutrophils (p = 0.006) and a decrease in monocytes (p = 0.023), were more prominent in female patients than in male patients. However, there was no statistically significant gender difference in the percentage of lymphocytes. Conclusions:This study revealed the possibility of gender differences in drug allergy to anticancer drugs including platinum compounds. Furthermore, this study showed new findings on fluctuation of WBC count and blood cell fractionation after Alg reactions.

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Pharmaceutical Investigation for Individualized and Optimal Cancer Pharmacotherapy

Takato

2016

YAKUGAKU ZASSHI

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After the year 2000, the treatment of cancer remarkably changed, including the development of outpatient cancer chemotherapy. Meanwhile, we have encountered many clinical problems related to cancer patient pharmacy services. To resolve these problems, I have tried to establish the individualized and optimal cancer pharmacotherapy utilizing thê ndings of basic research. In this review, three topics of my research will be introduced. 1) In 2005, information regarding the genetic polymorphism of UGT1A1 28 was described in the package insert of the drug irinotecan in the United States. At that time, however, there was little similar information for Japanese patients. Through clinical research, we demonstrated that UGT1A1 6 was a signiˆcant factor for neutropenia, as induced by irinotecan. 2) Tyrosine kinase inhibitors are mainly used at aˆxed dose, but wide interpatient variability has been observed relative to their pharmacokinetics and/or pharmacodynamics. To overcome these variations, clinical and basic pharmacological research on erlotinib, sorafenib and sunitinib was carried out. Especially, in sunitinib therapy, we demonstrated that the breast cancer resistant protein in the intestine functions as a limiting factor for oral absorption, and that therapeutic drug monitoring could be helpful for avoiding severe toxicities, resulting in prolonged progression-free survival. 3) We quantitatively assessed side eŠect management by pharmacist intervention for outpatient chemotherapy. We calculated the improvement ratio between before and after pharmacist intervention, and found that 135 suggestions (50.8％) led to signiˆcant improvements, indicating that pharmacist intervention could be useful for attenuating the side eŠects of cancer chemotherapies.

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Gender Differences in Hematotoxicity Induced by Gemcitabine Monotherapy

Cited by 4 publications

References 3 publications

Measuring body composition using the bioelectrical impedance method can predict the outcomes of gemcitabine-based chemotherapy in patients with pancreatobiliary tract cancer

Measuring body composition using the bioelectrical impedance method can predict the outcomes of gemcitabine-based chemotherapy in patients with pancreatobiliary tract cancer

Gender Difference in Allergic Reactions and the Fluctuation of Blood Cells Induced by Platinum-based Anticancer Drugs

Pharmaceutical Investigation for Individualized and Optimal Cancer Pharmacotherapy

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