Age-Associated Hematological Toxicity in Patients with Metastatic Castration-Resistant Prostate Cancer Treated with Docetaxel in Clinical Practice

  • Marie-Rose B. S. CrombagEmail author
  • Aurelia H. M. de Vries Schultink
  • Jacobine G. C. van Doremalen
  • Hans-Martin Otten
  • Andries M. Bergman
  • Jan H. M. Schellens
  • Jos H. Beijnen
  • Alwin D. R. Huitema
Original Research Article



Older patients with metastatic castration-resistant prostate cancer (mCRPC) may be more prone to chemotherapy-induced hematological toxicity, but tailored docetaxel dosing guidelines in older patients are lacking because of conflicting data.


This study aims to evaluate the impact of older age on the incidence of hematological toxicity in patients with mCRPC treated with docetaxel in daily clinical practice.


This study included patients with mCRPC treated with docetaxel between January 2006 and January 2016 at the Netherlands Cancer Institute and Medical Center Slotervaart for whom dosing and hematological toxicity data were available from electronic patient records. We evaluated the impact of age on the incidence of grade 3 and 4 hematological toxicity.


In total, 175 patients treated with docetaxel were included in the analysis, with a median age of 67 years (range 47–86). Baseline hematological laboratory values were not age related. After the first treatment cycle, hematological toxicity occurred significantly more frequently in the oldest age quartile (25%, p = 0.02) than in the younger age quartiles (9%, 11%, and 7%, respectively, for age quartiles 1, 2, and 3).


The risk of hematological toxicity was significantly higher in the oldest age quartile than in younger patients with mCRPC treated with docetaxel in daily clinical practice.


Compliance with Ethical Standards


No sources of funding were used to assist in the conduct of this study or the preparation of this article.

Conflict of interest

JHB and JHMS are part-time employees and shareholders of Modra Pharmaceuticals and hold a patent on oral taxane pharmaceutical formulations. M-RBSC, AHMdVS, JGCvD, H-MO, AMB, and ADRH have no conflicts of interest that are directly relevant to the content of this article.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Marie-Rose B. S. Crombag
    • 1
    • 2
    Email author
  • Aurelia H. M. de Vries Schultink
    • 1
    • 2
  • Jacobine G. C. van Doremalen
    • 1
    • 3
  • Hans-Martin Otten
    • 4
  • Andries M. Bergman
    • 5
  • Jan H. M. Schellens
    • 2
    • 3
  • Jos H. Beijnen
    • 1
    • 2
    • 3
  • Alwin D. R. Huitema
    • 1
    • 2
    • 6
  1. 1.Department of Pharmacy and PharmacologyAntoni van Leeuwenhoek, The Netherlands Cancer Institute and MC SlotervaartAmsterdamThe Netherlands
  2. 2.Division of PharmacologyThe Netherlands Cancer InstituteAmsterdamThe Netherlands
  3. 3.Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical SciencesUtrecht UniversityUtrechtThe Netherlands
  4. 4.Division of Medical OncologyMC SlotervaartAmsterdamThe Netherlands
  5. 5.Division of Medical OncologyThe Netherlands Cancer InstituteAmsterdamThe Netherlands
  6. 6.Department of Clinical Pharmacy, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands

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