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Leukocyte nadir as ...
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Poikonen-Saksela, PaulaHelsinki Univ Hosp, Comprehens Canc Ctr, Helsinki, Finland.;Univ Helsinki, Helsinki, Finland.
(author)
Leukocyte nadir as a predictive factor for efficacy of adjuvant chemotherapy in breast cancer. Results from the prospective trial SBG 2000-1
- Article/chapterEnglish2020
Publisher, publication year, extent ...
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Informa UK Limited,2020
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LIBRIS-ID:oai:DiVA.org:uu-423818
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-423818URI
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https://doi.org/10.1080/0284186X.2020.1757149DOI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:143717713URI
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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Background: Retrospective studies have suggested that chemotherapy-induced leukopenia is associated with improved recurrence-free or overall survival. The SBG 2000-1 trial was designed to verify the favorable prognosis associated with chemotherapy-induced leukopenia in early breast cancer. Patients not experiencing chemotherapy-induced leukopenia were randomized into standard dosed or individually escalated chemotherapy doses based on the grade of leukopenia after a first standard dose.Patients and methods: 1452 women in Sweden and Denmark with operable node-positive or high-risk node-negative breast cancer aged 18-60 years were recruited to participate in this trial. Participants received a first FEC cycle at standard doses (600/60/600 mg/m(2)). Patients (n = 1052) with nadir leukopenia grade 0-2 after the first cycle were randomized between either 6 standard FEC or 6 tailored FEC courses with doses of epirubicin and cyclophosphamide escalated during courses 2 and 3 and thereafter aimed at achieving grade 3 leukopenia. Patients with nadir leukopenia grade 3-4 after the first course continued treatment with standard FEC. Results of the randomized comparison has been published previously. The present study focuses on chemotherapy-induced leukopenia as a covariable with outcome in randomized and non-randomized patients. The prognostic value of leukopenia after course 3, was studied in a Cox model adjusted for cumulative doses of epirubicin and cyclophosphamide. The association of chemotherapy-induced leukopenia with prognosis was a preplanned secondary endpoint for this trial.Results: The eight-year distant disease-free survival was 73%, 77%, 78% and 83% for patients with leucocyte nadir grade 0, 1, 2 and 3-4, respectively. Higher degree of leukopenia was highly significantly associated to improved distant disease-free survival (HR 0.84, 95% CI 0.74-0.96, p = .008) and overall survival (HR 0.87 (0.76-0.99, p = .032).Conclusion: This prospective study confirms that chemotherapy-induced leukopenia is a covariable with outcome in primary breast cancer, even after adjustment for chemotherapy doses.
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Lindman, HenrikUppsala universitet,Experimentell och klinisk onkologi(Swepub:uu)henrlind
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Sverrisdottir, AsgerdurSodersjukhuset, Dept Oncol, Stocholm, Sweden.;Landspitali Univ Hosp, Dept Oncol, Reykjavik, Iceland.
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Edlund, PerGävle Cent Hosp, Dept Oncol, Gävle, Sweden.
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Villman, KennethÖrebro Univ Hosp, Dept Oncol, Örebro, Sweden.
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Nittby, Lena TennvallSkane Univ Hosp, Dept Oncol, Malmö, Sweden.
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Cold, SorenOdense Univ Hosp, Dept Oncol, Odense, Denmark.
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Bechmann, TroelsHosp South West Jutland, Dept Oncol, Esbjerg, Denmark.;Vejle Hosp, Dept Oncol, Vejle, Denmark.
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Stenbygaard, LarsAalborg Univ Hosp, Dept Oncol, Aalborg, Denmark.
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Ejlertsen, BentRigshosp, Dept Oncol, Copenhagen, Denmark.
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Andersson, MichaelRigshosp, Dept Oncol, Copenhagen, Denmark.
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Blomqvist, CarlHelsinki Univ Hosp, Comprehens Canc Ctr, Helsinki, Finland.;Univ Helsinki, Helsinki, Finland.;Örebro Univ Hosp, Dept Oncol, Örebro, Sweden.
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Bergh, JonasKarolinska Institutet
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Ahlgren, JohanGävle Cent Hosp, Dept Oncol, Gävle, Sweden.(Swepub:uu)joahl839
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Helsinki Univ Hosp, Comprehens Canc Ctr, Helsinki, Finland.;Univ Helsinki, Helsinki, Finland.Experimentell och klinisk onkologi
(creator_code:org_t)
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In:Acta Oncologica: Informa UK Limited59:7, s. 825-8320284-186X1651-226X
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Poikonen-Saksela ...
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Edlund, Per
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Villman, Kenneth
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Cold, Soren
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Bechmann, Troels
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Bergh, Jonas
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