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Hematologic toxicity during craniospinal irradiation: the impact of prior chemotherapy.

Publication ,  Journal Article
Marks, LB; Cuthbertson, D; Friedman, HS
Published in: Med Pediatr Oncol
July 1995

The purpose of this work was to determine the frequency of hematologic toxicity during craniospinal radiation (CSI) and the impact of preirradiation chemotherapy on this frequency. The charts of 37 patients who received CSI were reviewed. Twenty did not have prior chemotherapy (CT-), while 17 did receive 1 to 18 (mean 5) cycles of multi-agent systemic chemotherapy (CT+). Leukopenia/thrombocytopenia necessitating treatment interruptions occurred in 1/20 (5%) in the CT- group, compared to 8/17 (47%) among the CT+ group. This difference was statistically significant, P < 0.0001 (Fisher's exact two-tailed test). The duration of treatment interruption in the CT+ patients was 4-24 days (mean 14). Compared to the CT- group, the CT+ group had a statistically significant greater decline in their white blood cell count (WBC), platelet count, and hematocrit (HCT) during CSI (percent reduction per Gy; (P = 0.018, 0.006, and 0.047, respectively). Although not statistically significant, the CT+ group also experienced lower nadir ratios (nadir count/baseline count) in terms of WBC and platelets (P = 0.07 and 0.22, respectively). While the mean pretreatment baseline blood counts were lower in the CT+ group compared to the CT- group, these differences reached statistical significance for the HCT (P = 0.02), but not the WBC (P = 0.59) or platelets (P = 0.43). Leukopenia and thrombocytopenia are very common in patients who receive craniospinal irradiation following multi-agent systemic chemotherapy. This appears to be due to more rapid and marked reductions in counts during CSI. Since this toxicity may cause treatment interruptions that are potentially therapeutically disadvantageous, aggressive hematologic support with transfusions and growth factors may be necessary. This problem may become more common as combined modality therapy is used more frequently.

Duke Scholars

Published In

Med Pediatr Oncol

DOI

ISSN

0098-1532

Publication Date

July 1995

Volume

25

Issue

1

Start / End Page

45 / 51

Location

United States

Related Subject Headings

  • Spinal Cord
  • Radiation Injuries
  • Oncology & Carcinogenesis
  • Infant
  • Humans
  • Hematologic Diseases
  • Cranial Irradiation
  • Child, Preschool
  • Child
  • Central Nervous System Neoplasms
 

Citation

APA
Chicago
ICMJE
MLA
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Marks, L. B., Cuthbertson, D., & Friedman, H. S. (1995). Hematologic toxicity during craniospinal irradiation: the impact of prior chemotherapy. Med Pediatr Oncol, 25(1), 45–51. https://doi.org/10.1002/mpo.2950250110
Marks, L. B., D. Cuthbertson, and H. S. Friedman. “Hematologic toxicity during craniospinal irradiation: the impact of prior chemotherapy.Med Pediatr Oncol 25, no. 1 (July 1995): 45–51. https://doi.org/10.1002/mpo.2950250110.
Marks LB, Cuthbertson D, Friedman HS. Hematologic toxicity during craniospinal irradiation: the impact of prior chemotherapy. Med Pediatr Oncol. 1995 Jul;25(1):45–51.
Marks, L. B., et al. “Hematologic toxicity during craniospinal irradiation: the impact of prior chemotherapy.Med Pediatr Oncol, vol. 25, no. 1, July 1995, pp. 45–51. Pubmed, doi:10.1002/mpo.2950250110.
Marks LB, Cuthbertson D, Friedman HS. Hematologic toxicity during craniospinal irradiation: the impact of prior chemotherapy. Med Pediatr Oncol. 1995 Jul;25(1):45–51.

Published In

Med Pediatr Oncol

DOI

ISSN

0098-1532

Publication Date

July 1995

Volume

25

Issue

1

Start / End Page

45 / 51

Location

United States

Related Subject Headings

  • Spinal Cord
  • Radiation Injuries
  • Oncology & Carcinogenesis
  • Infant
  • Humans
  • Hematologic Diseases
  • Cranial Irradiation
  • Child, Preschool
  • Child
  • Central Nervous System Neoplasms