Risk factors (abstract)
PURPOSE:
Pegylated
liposomal doxorubicin (PLD) is widely used in relapsing ovarian
carcinoma. Its original formulation is metabolized by the
monocyte-macrophage system. One of its main toxicities is the
palmoplantar erythrodysesthesia (PPE) syndrome. To date, no predictive
factors of PPE have been identified.
METHODS:
Data
of patients (pts) treated with PLD between 2005 and 2014 were
retrospectively collected. A case-control study was performed, comparing
main baseline clinical and biological characteristics of pts
experiencing PPE and those who did not, after at least three cycles of
PLD. A pilot analysis of blood monocyte subpopulations (classical,
intermediate and non-classical) was performed by FACS in selected pts.
RESULTS:
Among
88 pts treated with PLD, 28 experienced PPE of any grade (31, 95 % CI
21-41). The first occurrence of PPE was at first cycle in only 11 % of
pts, peaked at cycle 2 (32 %) and represented 57 % of cases after cycle
3. Baseline characteristics of pts with PPE were compared to 27 control
pts who received at least 3 cycles. Older pts represented 61 % of pts
with PPE and 15 % of pts without PPE (p = 0.04 by Chi-square test).
Monocyte count and inflammatory parameters were not associated with PPE.
However, the analysis of monocyte subpopulations revealed a large
inter-patient variability.
CONCLUSION:
Contrary
to most acute toxicities, PPE occurred more frequently after several
cycles, suggesting a PLD body accumulation through repeated cycles. PPE
was more frequent in pts older than 70 years. Monocyte subpopulations
may have different roles on PLD metabolism and warrant further studies.
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