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Hematological adverse events in the management of glioblastoma

  • Clinical Study
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

Background

Hematological adverse events (HAEs) are common during treatment for glioblastoma (GBM), usually associated with temozolomide (TMZ). Their clinical value is uncertain, as few investigations have focused on outcomes for HAEs during GBM treatment.

Methods

We combined data from two randomized clinical trials, RTOG 0525 and RTOG 0825, to analyze HAEs during treatment for GBM. We investigated differences between chemoradiation and adjuvant therapy, and by regimen received during adjuvant treatment.

Results

1454 patients participated in these trials, of which 1154 (79.4%) developed HAEs. During chemoradiation, 44.4% of patients developed HAEs (54% involving more than one cell line), and were most commonly lymphopenia (50.6%), and thrombocytopenia (47.5%). During adjuvant treatment, 45% of patients presented HAEs (78.6% involving more than one cell line), and were more commonly leukopenia (62.7%), and thrombocytopenia (62.3%). Median overall survival (OS) and progression free survival (PFS) were longer in patients with HAEs (OS 19.4 months and PFS 9.9 months) compared to those with other or no adverse events (OS 14.1 months and PFS 5.9 months). There was no significant difference in survival between grade 1 and/or 2 versus grade 3 and/or 4 HAEs. History of HAEs during chemoradiation was a protective factor for presentation of HAEs during adjuvant therapy.

Conclusion

HAEs are common during GBM treatment, and often involve more than one cell line (more likely during adjuvant therapy). HAEs may be associated with prolonged OS and PFS, particularly during adjuvant therapy. HAEs during chemoradiation was a protective factor for HAEs during adjuvant therapy.

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Data availability

Data sharing not applicable to this article. Data was requested through the National Clinical Trials Network.

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Acknowledgement

Our investigation would not be possible without data support from RTOG central office, along with RTOG 0525 and 0825 investigators and the many participating patients.

Funding

Supported by the Biostatistics and Bioinformatics Shared Resource of the University of Kentucky Markey Cancer Center (P30 CA177558).

Author information

Authors and Affiliations

  1. Department of Neurology, Baylor College of Medicine, Houston, TX, USA

    Catherine R. Garcia

  2. Markey Cancer Center, University of Kentucky, Lexington, KY, 40536-0293, USA

    Zin W. Myint, Rani Jayswal, Chi Wang, Heidi L. Weiss & John L. Villano

  3. Division of Medical Oncology, University of Kentucky, Lexington, KY, USA

    Zin W. Myint, Rani Jayswal & John L. Villano

  4. Division of Cancer Biostatistics, Department of Internal Medicine, University of Kentucky, Lexington, KY, USA

    Chi Wang

  5. Department of Pharmacy Services, University of Kentucky, Lexington, KY, USA

    Rachael M. Morgan & Allison R. Butts

  6. Department of Neurology, University of Kentucky, Lexington, KY, USA

    John L. Villano

  7. Department of Neurosurgery, University of Kentucky, Lexington, KY, USA

    John L. Villano

Authors
  1. Catherine R. Garcia
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  2. Zin W. Myint
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  3. Rani Jayswal
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  4. Chi Wang
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  5. Rachael M. Morgan
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  6. Allison R. Butts
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  7. Heidi L. Weiss
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  8. John L. Villano
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Contributions

CRG: conceptualization, methodology, writing—original draft, and writing—review and editing; ZWM: writing—original draft, and writing—review and editing; RJ: formal analysis, writing—review and editing; CW: formal analysis, writing—review and editing; AB: review and editing; HW: review and editing; JV: funding acquisition, conceptualization, review and editing.

Corresponding author

Correspondence to John L. Villano.

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None of the authors has any conflicts to declare.

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This article does not contain any studies with human participants performed by any of the authors. Data was requested through the National Clinical Trials Network.

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Garcia, C.R., Myint, Z.W., Jayswal, R. et al. Hematological adverse events in the management of glioblastoma. J Neurooncol 156, 153–161 (2022). https://doi.org/10.1007/s11060-021-03891-8

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  • DOI: https://doi.org/10.1007/s11060-021-03891-8

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