Cancer Chemotherapy and Pharmacology

, Volume 76, Issue 6, pp 1217–1224 | Cite as

Chemotherapy-induced neutropenia as a prognostic factor in patients with unresectable pancreatic cancer

  • Tatsuya KuriharaEmail author
  • Mari Kogo
  • Masakazu Ishii
  • Ken Shimada
  • Keiichiro Yoneyama
  • Katsuya Kitamura
  • Shunichi Shimizu
  • Hitoshi Yoshida
  • Yuji Kiuchi
Original Article



We conducted a retrospective cohort study to examine whether neutropenia could be an indicator of good prognosis in patients treated with gemcitabine (GEM) for unresectable pancreatic cancer.


A total of 178 patients with unresectable pancreatic cancer, who were treated with first-line (n = 121) or second-line (n = 57) GEM, were included in our analyses. A Cox proportional hazard model was used to examine the effect of the grade of GEM-induced neutropenia on prognosis. Furthermore, the difference in survival time for each grade was assessed using a log-rank test.


In the first-line population, the hazard ratios of patients with grade 2 or grade 3 neutropenia compared with the ratios of those without neutropenia (grade 0) were 0.43 (95% CI 0.27–0.70) and 0.37 (0.21–0.65), respectively (p < 0.05). The median survival time (MST) was 3.8 months for grade 0, 9.4 months for grade 2, and 10.1 for grade 3. Landmark analysis of the second-line population revealed a hazard ratio of 0.52 (0.30–0.82) for grade 1 and 0.49 for grade 2 (0.28–0.72) (p < 0.05). MST was 1.3 months for grade 0, 4.7 months for grade 1, and 4.6 months for grade 2.


We found that neutropenia grade was an indicator of good prognosis in patients treated with first-line and second-line GEM for unresectable pancreatic cancer. A prospective study should be performed to examine whether dosage adjustment using neutropenia grade as an indicator would improve prognosis.


Unresectable pancreatic cancer Neutropenia Gemcitabin Prognosis 



We thank Jun Kawazoe, Emi Katsumoto, Wakana Kato, Saori Mochida, Megumi Mori, who are students at the Showa University School of Pharmacy, for their technical assistance.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Tatsuya Kurihara
    • 1
    Email author
  • Mari Kogo
    • 2
  • Masakazu Ishii
    • 1
  • Ken Shimada
    • 3
  • Keiichiro Yoneyama
    • 4
  • Katsuya Kitamura
    • 5
  • Shunichi Shimizu
    • 1
  • Hitoshi Yoshida
    • 5
  • Yuji Kiuchi
    • 6
  1. 1.Division of Physiology and Pathology, Department of Pharmacology, Toxicology and TherapeuticsShowa University School of PharmacyShinagawa-kuJapan
  2. 2.Department of Hospital PharmaceuticsShowa University School of PharmacyShinagawa-kuJapan
  3. 3.Division of Medical Oncology, Department of MedicineShowa University Koto-Toyosu HospitalKoto-kuJapan
  4. 4.Health Service CenterShowa UniversityShinagawa-kuJapan
  5. 5.Division of Gastroenterology, Department of MedicineShowa University School of MedicineShinagawa-kuJapan
  6. 6.Center of Pharmaceutical Education, School of Pharmaceutical SciencesShowa UniversityShinagawa-kuJapan

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