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. 2022 Jan 3;2(1):15-24.
doi: 10.21873/cdp.10071. eCollection 2022 Jan-Feb.

Hyaluronic Acid May Be a Predictive Biomarker for Thrombocytopenia and Liver Dysfunction After Oxaliplatin-based Chemotherapy

Takashi Miyata  1 , Yasuto Tomita  1 , Yuta San-Nomiya  1 , Taigo Nagayama  1 , Ryosuke Kin  1 , Hisashi Nishiki  1 , Akifumi Hashimoto  1 , Yoritaka Fujii  1 , Seiko Miura  1 , Daisuke Kaida  1 , Naohiko Nakamura  1 , Tomoharu Miyashita  1 , Hideto Fujita  1 , Nobuhiko Ueda  1 , Hiroyuki Takamura  1
Affiliations

Hyaluronic Acid May Be a Predictive Biomarker for Thrombocytopenia and Liver Dysfunction After Oxaliplatin-based Chemotherapy

Takashi Miyata et al. Cancer Diagn Progn. .

Abstract

Background/aim: Following oxaliplatin-based chemotherapy, approximately half of all colorectal cancer patients develop sinusoidal obstruction syndrome (SOS). SOS can be monitored by measuring splenic volume; however, obtaining this measurement is not a simple process. In this study, we evaluated changes in hyaluronic acid (HA) concentrations as a simpler marker of SOS.

Patients and methods: We measured splenic volume and laboratory data, including hyaluronic acid concentration, liver enzymes, and platelet counts, in 34 patients with colorectal cancer who underwent radical resection and who received capecitabine plus oxaliplatin (CapeOx) chemotherapy.

Results: A strong correlation was identified between ≥30% increase in splenic volume and significantly elevated HA concentrations. Affected patients also had persistent thrombocytopenia and liver dysfunction compared to patients without elevated HA concentration.

Conclusion: HA concentration may predict SOS in patients who receive CapeOx adjuvant chemotherapy.

Keywords: Hyaluronic acid; oxaliplatin; sinusoidal obstruction syndrome; splenic volume.

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Conflict of interest statement

The Authors declare they have no financial or other conflicts of interest.

Figures

Figure 1
Figure 1. Changes in laboratory data. (A) Changes in laboratory data for all patients. (B) Patients in whom splenic volume (SV) increased ≥30% after adjuvant chemotherapy compared with before treatment. (C) Patients in whom SV did not increase by ≥30%. HA: Hyaluronic acid, PLT: platelet count, AST: serum aspartate aminotransferase, ALT: alanine aminotransferase, γ-GT: γ-glutamyl transpeptidase.
Figure 1
Figure 1. Changes in laboratory data. (A) Changes in laboratory data for all patients. (B) Patients in whom splenic volume (SV) increased ≥30% after adjuvant chemotherapy compared with before treatment. (C) Patients in whom SV did not increase by ≥30%. HA: Hyaluronic acid, PLT: platelet count, AST: serum aspartate aminotransferase, ALT: alanine aminotransferase, γ-GT: γ-glutamyl transpeptidase.
Figure 1
Figure 1. Changes in laboratory data. (A) Changes in laboratory data for all patients. (B) Patients in whom splenic volume (SV) increased ≥30% after adjuvant chemotherapy compared with before treatment. (C) Patients in whom SV did not increase by ≥30%. HA: Hyaluronic acid, PLT: platelet count, AST: serum aspartate aminotransferase, ALT: alanine aminotransferase, γ-GT: γ-glutamyl transpeptidase.
Figure 2
Figure 2. Increase in the splenic volume (SV) ratio after adjuvant chemotherapy compared with before treatment (A), 6 months after treatment (B), and 1 year after treatment (C).
Figure 3
Figure 3. Magnitude of the percentage change in splenic volume in relation to the magnitude of the percentage change in HA levels after adjuvant chemotherapy.
Figure 4
Figure 4. The hyaluronic acid (HA) cutoff value was 183 ng/ml, calculated using a receiver operating characteristic curve in a predictive model for sinusoidal obstruction syndrome, shown as the boundary between Groups A and B.
Figure 5
Figure 5. Liver histology showing atrophic hepatocytes with moderate sinusoidal injury and lymphocyte infiltration in a patient with an HA level of 246 ng/ml (A). However, the liver tissue was almost normal in a patient with an HA level of 92 ng/ml (B) (magnification ×100, hematoxylin & eosin (H&E) stain, for both images).
See this image and copyright information in PMC

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