Yang Liu1, Yongde Cao1, Leting Xiao1, Haijiang Wang2. 1. Department of Gastrointestinal Surgery, The Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China. 2. Department of Gastrointestinal Surgery, The Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China. wanghaijiang9696@163.com.
Abstract
PURPOSE: Some cancer patients experience an increase in the leukocyte count, platelet count, and absolute neutrophil count compared to the baseline level after chemotherapy. We identify this phenomenon as "myelostimulation", which seems to go against the myelosuppression properties of chemotherapy drugs. However, the clinical value of "myelostimulation" that appears early after fluorouracil plus platinum-based neoadjuvant chemotherapy (NACT) in patients with locally advanced gastric cancer (LAGC) remains unclear. METHOD: Patients with LAGC who underwent fluorouracil plus platinum-based NACT and radical resection from January 2010 to January 2015 were included. Patients were divided into an increased group and a decreased group based on the leukocyte count, platelet count, and absolute neutrophil count in the early stage after NACT, compared with the baseline blood routine examination results. The prognosis was compared between the increased group and the decreased group. RESULTS: The 3-year PFS and 5-year OS of the group with increased leukocyte count, platelet count, and absolute neutrophil count were significantly lower compared to those of the decreased group. Based on the multivariate analysis, increased absolute neutrophil count is an independent risk factor for 3-year PFS (P < 0.001, HR 3.003, 95% CI 1.639-5.495) and 5-year OS (P = 0.003, HR 2.611, 95% CI 1.374-4.950), and increased platelet count is an independent risk factor for 5-year OS (P = 0.037, HR 2.033, 95% CI 1.044-3.953). CONCLUSION: The "myelostimulation" that occurs in patients with LAGC in the early stage (3-5 days) after fluorouracil plus platinum-based NACT is related to a poor prognosis, which is a simple and effective method to screen related patients with unfavored outcomes. Notably, the increase in absolute neutrophil count and platelet count has been proved to be an independent risk factor.
PURPOSE: Some cancer patients experience an increase in the leukocyte count, platelet count, and absolute neutrophil count compared to the baseline level after chemotherapy. We identify this phenomenon as "myelostimulation", which seems to go against the myelosuppression properties of chemotherapy drugs. However, the clinical value of "myelostimulation" that appears early after fluorouracil plus platinum-based neoadjuvant chemotherapy (NACT) in patients with locally advanced gastric cancer (LAGC) remains unclear. METHOD: Patients with LAGC who underwent fluorouracil plus platinum-based NACT and radical resection from January 2010 to January 2015 were included. Patients were divided into an increased group and a decreased group based on the leukocyte count, platelet count, and absolute neutrophil count in the early stage after NACT, compared with the baseline blood routine examination results. The prognosis was compared between the increased group and the decreased group. RESULTS: The 3-year PFS and 5-year OS of the group with increased leukocyte count, platelet count, and absolute neutrophil count were significantly lower compared to those of the decreased group. Based on the multivariate analysis, increased absolute neutrophil count is an independent risk factor for 3-year PFS (P < 0.001, HR 3.003, 95% CI 1.639-5.495) and 5-year OS (P = 0.003, HR 2.611, 95% CI 1.374-4.950), and increased platelet count is an independent risk factor for 5-year OS (P = 0.037, HR 2.033, 95% CI 1.044-3.953). CONCLUSION: The "myelostimulation" that occurs in patients with LAGC in the early stage (3-5 days) after fluorouracil plus platinum-based NACT is related to a poor prognosis, which is a simple and effective method to screen related patients with unfavored outcomes. Notably, the increase in absolute neutrophil count and platelet count has been proved to be an independent risk factor.
Authors: E A Eisenhauer; P Therasse; J Bogaerts; L H Schwartz; D Sargent; R Ford; J Dancey; S Arbuck; S Gwyther; M Mooney; L Rubinstein; L Shankar; L Dodd; R Kaplan; D Lacombe; J Verweij Journal: Eur J Cancer Date: 2009-01 Impact factor: 9.162
Authors: Kathryn E Cole; Quan P Ly; Michael A Hollingsworth; Jesse L Cox; Kurt W Fisher; James C Padussis; Jason M Foster; Luciano M Vargas; James E Talmadge Journal: Int Immunopharmacol Date: 2022-02-21 Impact factor: 4.932