Predictive value of baseline plasma D-dimers for chemotherapy- induced thrombocytopenia in patients with stage III colon cancer: a pilot study

Asian Pac J Cancer Prev. 2013;14(1):293-7. doi: 10.7314/apjcp.2013.14.1.293.

Abstract

Background: Chemotherapy-induced thrombocytopenia (CIT) is an important cause of morbitity in patients with cancer.

Aim: To investigate the effect of the baseline plasma D-dimer level, an important marker for thrombotic activity, on chemotherapy-induced thrombocytopenia in patients with stage III colon cancer.

Materials and methods: A total of 43 (28 men) eligible patients were divided into two groups according to whether they exhibited chemotherapy-induced thrombocytopenia: Group 1 (n=21) and Group 2 (n=22). Comparison was made using demographic, histopathologic, and laboratory variables. Additionally, baseline plasma D-dimer levels underwent receiver operation characteristics curve analysis, and areas under the curve were calculated. Sensitivity, specificity, and positive and negative likelihood rates were then determined.

Results: The incidence of chemotherapy-induced thrombocytopenia had a significant correlation with baseline platelet count (r=0.568, P=0.031) and baseline plasma D-dimer levels (r=0.617, P=0.036). When the cut-off point for the latter was set as 498 ng/mL, the area under the curve was 0.89 (95%CI: 0.74-0.93), the sensitivity was 91.4%, the specificity was 89.7%, the positive likelihood rate was 3.64 and the negative likelihood rate was 0.24 for chemotherapy-induced thrombocytopenia diagnosis.

Conclusions: The baseline level of plasma D-dimer could help to differentiate high- risk patients for chemotherapy-induced thrombocytopenia.

MeSH terms

  • Adult
  • Analysis of Variance
  • Anemia / blood
  • Anemia / chemically induced
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Area Under Curve
  • Biomarkers / blood
  • Colonic Neoplasms / drug therapy*
  • Female
  • Fibrin Fibrinogen Degradation Products / metabolism*
  • Fluorouracil / adverse effects
  • Humans
  • Leucovorin / adverse effects
  • Male
  • Middle Aged
  • Neutropenia / blood
  • Neutropenia / chemically induced
  • Organoplatinum Compounds / adverse effects
  • Pilot Projects
  • Platelet Count
  • Predictive Value of Tests
  • ROC Curve
  • Retrospective Studies
  • Statistics, Nonparametric
  • Thrombocytopenia / blood*
  • Thrombocytopenia / chemically induced*

Substances

  • Biomarkers
  • Fibrin Fibrinogen Degradation Products
  • Organoplatinum Compounds
  • fibrin fragment D
  • Leucovorin
  • Fluorouracil

Supplementary concepts

  • Folfox protocol