Influencing Factors Of Severe Myelosuppression Induced By Chemotherapy For The First Time In Neuroblastoma

Objective:To study the influencing factors of severe myelosuppression induced by chemotherapy for neuroblastoma for the first time,so as to take preventive measures in the future clinical treatment.Methods: Severe myelosuppression group in 18 cases(34.6%),no or mild myelosuppression group in 34 cases(65.3%),32 males and 20 females,aged 2-12 years,mean age(2.90±0.67)years old,weight The index(BMI)was <13 kg/m2 in 2 cases,>20 kg/m2 in 3 cases,and 13~20 kg/m2 in 47 cases.There were 32 patients with bone marrow metastasis,20 patients without bone marrow metastasis,41 patients with 98A3,11 patients with 98A1,8 patients with stage III tumors,44 patients with stage IV tumors,and 51 patients with retroperitoneal tumors.1 in other sites.Before the first chemotherapy,the number of leukocytes was <5.0*109/L in 4 cases,?5.0*109/L in 48 cases,and the number of platelets before the first chemotherapy was <125*109/L in 8 cases,?125*.109/L was 44 cases.Before the first chemotherapy,hemoglobin was less than 90g/L in 18 cases,and ?90g/L in 34 cases.Comparing the two groups of data,there was a statistically significant relationship between age and severe myelosuppression after the first chemotherapy(P<0.05).The age of patients with age less than 1 year in the severe myelosuppression group was significantly higher than that in the mild or no myelosuppressed group.The relationship between bone marrow metastasis and severe myelosuppression after the first chemotherapy in both groups was statistically significant(P<0.05).The patients with bone marrow metastasis who received chemotherapy for the first time had a higher rate of severe bone marrow suppression.There was a statistically significant relationship between the two groups of chemotherapy regimens and the first chemotherapy with severe myelosuppression(P<0.05).The first chemotherapy with 98A3 regimen induced a higher rate of severe bone marrow suppression.The results showed that sex,BMI,tumor stage tumor location,leukocyte count before chemotherapy<5.0*109/L,platelet count before chemotherapy<125*109/L,hemoglobin count before chemotherapy<90 g/L and severe myelosuppression at first chemotherapy No statistical significance(P>0.05).Conclusion:A high proportion of severe bone marrow suppression occurs after the first chemotherapy in patients with neuroblastoma.Age,intensity of chemotherapeutic drugs and bone marrow metastasis are the main factors leading to severe myelosuppression after the first chemotherapy.In the first chemotherapy of clinical neuroblastoma,individual treatment options should be selected according to the specific conditions of children.