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. 2021 May;106(5):662-672.
doi: 10.1111/ejh.13595. Epub 2021 Feb 16.

The incidence of thrombocytopenia in adult patients receiving chemotherapy for solid tumors or hematologic malignancies

Jaime L Shaw  1 , Carrie M Nielson  1 , Joseph K Park  1 , Andrea Marongiu  2 , Gerald A Soff  3
Affiliations

The incidence of thrombocytopenia in adult patients receiving chemotherapy for solid tumors or hematologic malignancies

Jaime L Shaw et al. Eur J Haematol. 2021 May.

Abstract

Objectives: To estimate the risk of thrombocytopenia in various cancers and chemotherapy regimens.

Methods: Structured patient-level data from the Flatiron Health Electronic Health Record database were used to identify adult patients who received chemotherapy for a solid tumor or hematologic malignancy from 2012 to 2017. Three-month cumulative incidence of thrombocytopenia was assessed based on platelet counts, overall and by grade of thrombocytopenia. Co-occurrence of anemia, neutropenia, and leukopenia was evaluated.

Results: Of 15,521 patients with solid tumors, 13% had thrombocytopenia within 3 months (platelet count < 100 × 109 /L); 4% had grade 3 (25 to < 50 × 109 /L), and 2% grade 4 (<25 × 109 /L) thrombocytopenia. Of 2537 patients with hematologic malignancies, 28% had any thrombocytopenia, 16% with grade 3, and 12% with grade 4. Among patients with thrombocytopenia, it occurred without another cytopenia in 18% of solid tumors and 7% of hematologic malignancies.

Conclusions: In a large, US-representative sample of patients undergoing chemotherapy in clinical practice, thrombocytopenia incidence varied across tumor and regimen types. Despite recommendations to alter chemotherapy to avoid severe thrombocytopenia, 4% of patients with solid tumors and 16% with hematologic malignancies experienced grade 3 thrombocytopenia. Prediction and prevention of thrombocytopenia may help oncologists avoid dose modifications and their adverse effects on survival.

Keywords: CIT; Thrombocytopenia; adverse event; chemotherapy; chemotherapy-induced thrombocytopenia; hematologic malignancy; incidence; solid tumor; toxicity.

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Conflict of interest statement

JS, CN, AM, and JP are Amgen employees and have stock ownership in Amgen Inc; GS is and has been a clinical investigator for Amgen and trials.

Figures

FIGURE 1
FIGURE 1
Three‐month cumulative incidence and 95% confidence intervals of thrombocytopenia, by grade of severity, for solid tumor (A), hematologic malignancy (B), and chemotherapy regimen categories (C). For results in tabular format, see Table S2
FIGURE 2
FIGURE 2
Three‐month cumulative incidence (%) of thrombocytopenia following chemotherapy by cancer type. CI, confidence interval
FIGURE 3
FIGURE 3
Percent of thrombocytopenic patients with co‐occurring cytopenia (among patients with complete lab values at first evidence of thrombocytopenia). For results in tabular format, see Table S3
See this image and copyright information in PMC

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