Clinic Analysis Of Myelosuppression Caused By High-Dose Chemotherapy For Osteosarcoma

Objective:To conclude the reference value range of how long the chemotherapy-induced myelosuppression will appear, last and recovery; To analyze and find out the relevant risk factors; To present clinical evidence for the prophylaxis and treatment of chemotherapy-induced myelosuppression.Methods:Selected and retrospectively studied63courses of chemotherapies of17patients diagnosed of osteosarcoma from QILU Hospital attached to Shandong University(from May2011to January2013).All the patients were diagnosed definitely according to clinical, imagining and pathological diagnosis.The regimen of used for osteosarcoma was made of cisplatin, doxorubicine, ifosfamide.The dose of chemotherapy drugs was calculated by body surface area, along with some other factors such as the age, the nutritional status of the patients, etc. We collected all the informations of the63courses of chemotherapies we needed and formulated them. We calculated the reference value ranges of the time variation of the chemotherapy-induced myelosuppression for WBC, NEU, PLT. Then we did univariate analysis for the risk factors which were probably relevant to it, then we chose the significant factors(P<0.05) and did the multiple linear regression.All the data we got were calculated using statistics methods by the SPSS17.0software. We choose the significant factor(P<0.05).Results:With the chemotherapy regimen of DDP+ADM+IFO in our treatment center for osteosarcoma.there were60courses occurring grade Ⅲ/Ⅳ myelosuppression with the incidence of95.2%in all.However, after the suitable treatments including the use of G-CSF、EPO、TPO、antibiotics and blood transfusion, all patients who suffered grade Ⅲ/Ⅳ myelosuppression recovered completely and no patients died of it.We found that after the chemotherapy, WBC would hit to the nadir for about5.08±2.18days,last below the lower limit for about3.28±3.07days and rise to the normal for about4.06±3.96days.By the ways, NEU would fall to the nadir for about6.16±1.84days and PLT for about6.94±2.47days. In the univariate analysis, the significant factors (P<0.05) were as follows:gender, BMI classification and whether the FN appeared after chemotherapies. In the multiple linear regression analysis, the significant factors were gender and the highest body temperature after chemotherapies with BMI classification wept out. Furthermore, the time for WBC to the nadir was related to the dose of DDP, there was no statistically significant relation between age, gender, BMI classification, whether the operations performed,the forepassed chemotherapies and WBC to the nadir. And there was no statistically significant relation between age, gender, BMI classification, whether the operations performed, the forepassed chemotherapies and NEU/PLT to the nadir.Conclusions:1. The III/IV high-dose chemotherapy-induced myelosuppression is common in our treat-center.2.The reference value ranges of the time variation for chemotherapy-induced myelosuppression in our center were as follows:5.08±2.18days for WBC to the nadir,3.28±3.07days for the duration,4.06±3.96days to recovery. Furthermore, WBC got tis nadir first,NEU did the second,PLT the last.3.The risk factors for extending duration of myelosuppresion were as follows: gender, whether the FN appeared after the chemotherapy or not.The factors which were not relevant to the periods for the count of WBC, NEU, PLT to the nadirs were age, gender, BMI classification, whether the operations were performed and the numbers of chemotherapy courses that had been experienced. 4.The prophylaxis and treatments for the patients who suffered Ⅲ/Ⅳ chemotherapy-induced myelosuppression were effective.