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Mizrahi D, Park SB, Li T, Timmins HC, Trinh T, Au K, Battaglini E, Wyld D, Henderson RD, Grimison P, Ke H, Geelan-Small P, Marker J, Wall B, Goldstein D. Hemoglobin, Body Mass Index, and Age as Risk Factors for Paclitaxel- and Oxaliplatin-Induced Peripheral Neuropathy. JAMA Netw Open 2021; 4:e2036695. [PMID: 33587134 PMCID: PMC7885037 DOI: 10.1001/jamanetworkopen.2020.36695] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
IMPORTANCE Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating adverse effect of neurotoxic cancer treatments including taxanes and platinum agents. Limited knowledge exists of potential prechemotherapy factors associated with CIPN development. OBJECTIVE To identify the association of pretreatment blood-based and clinical factors with CIPN persistence in patients who received paclitaxel or oxaliplatin. DESIGN, SETTING, AND PARTICIPANTS This cohort study assessed pretreatment blood-based clinical factors and demographic characteristics of 333 patients treated with paclitaxel and oxaliplatin chemotherapy at urban multicenter cancer clinics and academic institutions in Australia between September 2015 and February 2020. Comprehensive neuropathy assessments were undertaken 3 to 12 months posttreatment. Posttreatment CIPN severity was compared with blood-based factors within 30 days prior to commencing chemotherapy. Data were analyzed between March and December 2020. EXPOSURES Paclitaxel or oxaliplatin chemotherapy. MAIN OUTCOMES AND MEASURES CIPN was measured using composite neurological grading scales, nerve conduction studies, and assessments of fine motor skills (grooved pegboard test), sensory function (grating orientation test and 2-point discrimination), and patient-reported outcomes. Independent samples t tests and Mann-Whitney U tests with post hoc Bonferroni correction were used to compare CIPN between patients according to blood-based factor normative ranges. Linear regression was used to identify blood-based and clinical associations with CIPN development. RESULTS The study included 333 participants (266 [79.9%] women; median [interquartile range] age, 58 [18] years) who were consecutively recruited and referred (228 treated with paclitaxel, 105 treated with oxaliplatin; 138 [41.4%] with breast cancer, 83 [24.9%] with colorectal cancer). Most participants had grade 1 CIPN or higher (238 [71.5%] participants). Participants with low hemoglobin pretreatment had worse CIPN posttreatment (median [IQR] composite neurological grading scale score, 5 [2-8] vs 4 [1-6]; P = .002; grooved pegboard mean [SD] time, 84.2 [28.7] vs 72.9 [21.1] seconds; P = .002; grating orientation task, 4.8 [2.8] vs 3.9 [1.8] mm; P = .03; 2-point discrimination, 45% vs 28%; P = .01), with no other impairments outside normative ranges associated with CIPN. In the multivariable model, several factors were associated with worse CIPN (F4,315 = 18.6; P < .001; r2 = .19) including for lower hemoglobin (β = -0.47; 95% CI, -0.73 to -0.21; P < .001), higher body mass index (β = 0.08; 95% CI, 0.02 to 0.12; P = .007), older age (β = 0.08; 95% CI, 0.06 to 0.11; P < .001), and female sex (β = -1.08; 95% CI, -1.76 to -0.16; P = .01). CONCLUSIONS AND RELEVANCE The results of this cohort study suggest that participants with low pretreatment hemoglobin, higher body mass index, older age, and female sex were more likely to develop paclitaxel- or oxaliplatin-induced CIPN posttreatment. Future research should investigate prospectively whether these risk factors are associated with a higher incidence of CIPN development.
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Affiliation(s)
- David Mizrahi
- Prince of Wales Clinical School, UNSW Medicine, University of New South Wales Sydney, Sydney, Australia
| | - Susanna B. Park
- Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Tiffany Li
- Brain and Mind Centre, University of Sydney, Sydney, Australia
| | | | - Terry Trinh
- Prince of Wales Clinical School, UNSW Medicine, University of New South Wales Sydney, Sydney, Australia
| | - Kimberley Au
- Prince of Wales Clinical School, UNSW Medicine, University of New South Wales Sydney, Sydney, Australia
| | - Eva Battaglini
- Prince of Wales Clinical School, UNSW Medicine, University of New South Wales Sydney, Sydney, Australia
| | - David Wyld
- Royal Brisbane and Women’s Hospital, Brisbane, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Robert D. Henderson
- Royal Brisbane and Women’s Hospital, Brisbane, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Peter Grimison
- Chris O’Brien Lifehouse, Sydney, Australia
- Sydney Medical School, University of Sydney, Sydney, Australia
| | - Helen Ke
- Chris O’Brien Lifehouse, Sydney, Australia
| | - Peter Geelan-Small
- Mark Wainwright Analytical Centre, University of New South Wales, Kensington, Australia
| | - Julie Marker
- The Australasian Gastro-Intestinal Trials Group Consumer Advisory Panel, Sydney, Australia
| | - Brian Wall
- The Australasian Gastro-Intestinal Trials Group Consumer Advisory Panel, Sydney, Australia
| | - David Goldstein
- Prince of Wales Clinical School, UNSW Medicine, University of New South Wales Sydney, Sydney, Australia
- Department of Medical Oncology, Prince of Wales Hospital, Sydney, Australia
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Rössler J, Kaserer A, Spahn GH, Spahn DR. Not all anemia is solely due to iron deficiency. J Thorac Dis 2020; 12:1130-1132. [PMID: 32274185 PMCID: PMC7138976 DOI: 10.21037/jtd.2019.12.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Julian Rössler
- Institute of Anesthesiology, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Alexander Kaserer
- Institute of Anesthesiology, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Gabriela H Spahn
- Institute of Anesthesiology, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Donat R Spahn
- Institute of Anesthesiology, University of Zurich and University Hospital Zurich, Zurich, Switzerland
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Cai X, Zhu Q, Wu T, Zhu B, Liu S, Liu S, Aierken X, Ahmat A, Li N. Association of circulating resistin and adiponectin levels with Kawasaki disease: A meta-analysis. Exp Ther Med 2019; 19:1033-1041. [PMID: 32010266 PMCID: PMC6966156 DOI: 10.3892/etm.2019.8306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 11/05/2019] [Indexed: 12/12/2022] Open
Abstract
The present meta-analysis was performed to examine the association between circulating blood adipokine levels and Kawasaki disease (KD). Studies were identified by searching various databases, including Web of Science, EMBASE, PubMed, Wanfang and China National Knowledge Infrastructure. After the studies were pooled, the mean difference (MD) and corresponding 95% CI were calculated. Subgroup analyses and publication bias detection were also performed. The Cochrane Q test and I2 statistics were performed using Review Manager software (version 5.3) to test for heterogeneity. A Begg's test was used to assess publication bias and STATA software (version 12.0) was used for statistical analysis. The results revealed that the KD group exhibited higher levels of resistin compared with those in the healthy controls or disease controls (non-KD; MD=20.76, 95% CI=16.16-25.36, P<0.001; MD=21.27, 95% CI=14.24-28.29, P<0.001, respectively). In addition, when compared with those in patients exhibiting non-coronary artery lesions (NCAL), those with coronary artery lesions (CAL) had higher levels of adiponectin and resistin (MD=1.00, 95% CI=0.06-1.96, P=0.04; MD=2.77, 95% CI=1.32-4.22, P<0.001). Furthermore, compared with those in the inactive-phase group, patients in the active-phase group exhibited higher levels of resistin (MD=17.73, 95% CI=12.82-22.65, P<0.001). In conclusion, the present meta-analysis indicated that resistin levels were elevated in patients with KD. It was also revealed that circulating resistin and adiponectin levels in the CAL group were significantly increased compared with those in patients with NCAL. Furthermore, the active group had higher levels of resistin than the inactive group. The results of these meta-analyses indicated that resistin may serve an important role in the pathogenesis of KD and may therefore be used as biomarkers for the diagnosis of KD, whereas adiponectin may only serve an important role in the pathogenesis of CAL and may therefore be used as a biomarker to distinguish CAL from NCAL.
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Affiliation(s)
- Xintian Cai
- Center for Hypertension of The People's Hospital of Xinjiang Uygur Autonomous Region, Hypertension Institute of Xinjiang, Urumqi, Xinjiang 830001, P.R. China
| | - Qing Zhu
- Center for Hypertension of The People's Hospital of Xinjiang Uygur Autonomous Region, Hypertension Institute of Xinjiang, Urumqi, Xinjiang 830001, P.R. China
| | - Ting Wu
- Center for Hypertension of The People's Hospital of Xinjiang Uygur Autonomous Region, Hypertension Institute of Xinjiang, Urumqi, Xinjiang 830001, P.R. China
| | - Bin Zhu
- Center for Hypertension of The People's Hospital of Xinjiang Uygur Autonomous Region, Hypertension Institute of Xinjiang, Urumqi, Xinjiang 830001, P.R. China
| | - Shasha Liu
- Center for Hypertension of The People's Hospital of Xinjiang Uygur Autonomous Region, Hypertension Institute of Xinjiang, Urumqi, Xinjiang 830001, P.R. China
| | - Shanshan Liu
- Center for Hypertension of The People's Hospital of Xinjiang Uygur Autonomous Region, Hypertension Institute of Xinjiang, Urumqi, Xinjiang 830001, P.R. China
| | - Xiayire Aierken
- Center for Hypertension of The People's Hospital of Xinjiang Uygur Autonomous Region, Hypertension Institute of Xinjiang, Urumqi, Xinjiang 830001, P.R. China
| | - Ayguzal Ahmat
- Center for Hypertension of The People's Hospital of Xinjiang Uygur Autonomous Region, Hypertension Institute of Xinjiang, Urumqi, Xinjiang 830001, P.R. China
| | - Nanfang Li
- Center for Hypertension of The People's Hospital of Xinjiang Uygur Autonomous Region, Hypertension Institute of Xinjiang, Urumqi, Xinjiang 830001, P.R. China
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Dang Z, Liu X, Wang X, Li M, Jiang Y, Wang X, Yang Z. Comparative effectiveness and safety of traditional Chinese medicine supporting Qi and enriching blood for cancer related anemia in patients not receiving chemoradiotherapy: a meta-analysis and systematic review. Drug Des Devel Ther 2018; 13:221-230. [PMID: 30643388 PMCID: PMC6312692 DOI: 10.2147/dddt.s181182] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
A systematic review and meta-analysis of previous randomized controlled trials of traditional Chinese medicine (TCM) supporting Qi and enriching blood in the treatment of cancer related anemia (CRA) in patients not receiving chemoradiotherapy were conducted. A total of 13 randomized controlled trials were included. Compared with the control group, better improvement was found for the level of hemoglobin (mean difference=4.57, 95% CI [1.38, 7.76], P=0.005) and overall therapeutic effect (risk ratio [RR]=1.31, 95% CI [1.18, 1.46], P<0.000) in the TCM groups. The incidence of related adverse events was not increased in the TCM groups (RR=0.54, 95% CI [0.29, 0.99], P=0.05). However, due to the relatively low quality and the small sample sizes of the included studies, the results should be interpreted with a degree of caution. Nevertheless, TCM with the role of supporting Qi and enriching blood may be a safe and effective treatment for CRA in patients not receiving chemoradiotherapy and might be considered as an alternative treatment to conventional western medicine including iron supplements and erythropoietin.
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Affiliation(s)
- Zhibo Dang
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Chaoyang District, Beijing 100015, People's Republic of China,
- First Clinical Medical College, Beijing University of Chinese Medicine, Chaoyang District, Beijing 100029, People's Republic of China
| | - Xiaoli Liu
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Chaoyang District, Beijing 100015, People's Republic of China,
| | - Xinhui Wang
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Chaoyang District, Beijing 100015, People's Republic of China,
| | - Mengge Li
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Chaoyang District, Beijing 100015, People's Republic of China,
- First Clinical Medical College, Beijing University of Chinese Medicine, Chaoyang District, Beijing 100029, People's Republic of China
| | - Yuyong Jiang
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Chaoyang District, Beijing 100015, People's Republic of China,
| | - Xianbo Wang
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Chaoyang District, Beijing 100015, People's Republic of China,
| | - Zhiyun Yang
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Chaoyang District, Beijing 100015, People's Republic of China,
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Huang Y, Wei S, Jiang N, Zhang L, Wang S, Cao X, Zhao Y, Wang P. The prognostic impact of decreased pretreatment haemoglobin level on the survival of patients with lung cancer: a systematic review and meta-analysis. BMC Cancer 2018; 18:1235. [PMID: 30526532 PMCID: PMC6288911 DOI: 10.1186/s12885-018-5136-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Accepted: 11/26/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Many studies have reported the prognostic value of haemoglobin level for cancers. Whereas the prognostic impact of decreased pretreatment haemoglobin level on the survival of patients with lung cancer remains controversial, herein, a systematic review and meta-analysis were conducted to investigate whether a decreased haemoglobin level before treatment is a significant predictor of survival in patients with lung cancer. METHODS We performed a systematic review and meta-analysis of observational studies to evaluate the prognostic impact of a decreased haemoglobin level on the survival of patients with lung cancer. Relevant studies were retrieved from databases including PubMed, Embase, Web of Science and the Cochrane Library. Reference lists were hand-searched for potentially eligible studies. The Newcastle-Ottawa scale was used to assess the quality of included studies. Observational studies were included if they provided sufficient information for the extraction of the pooled hazard ratios (HR) and 95% confidence intervals (95% CI) for overall survival, disease-free survival, relapse-free survival, progression-free survival, event-free survival and time to progression. Subgroup analysis, meta-regression and sensitivity analyses were applied to explain the heterogeneity. RESULTS Fifty-five articles involving a total of 22,719 patients were obtained to evaluate the correlation between haemoglobin level and survival. The results indicated that decreased haemoglobin level was significantly associated with poor overall survival of patients with lung cancer (HR 1.51, 95% CI 1.42-1.61), both in non-small cell lung cancer (HR 1.57, 95% CI 1.44-1.72) and in small cell lung cancer (HR 1.56, 95% CI 1.21-2.02). We also found that the lower the haemoglobin level, the shorter was the overall survival of patients with lung cancer (HR 1.11, 95% CI 1.06-1.16). However, the relationship between decreased haemoglobin and relapse-free survival was not significant (HR 1.37, 95% CI 0.91-2.05). CONCLUSION A decreased pretreatment haemoglobin level among patients with lung cancer is a prognostic factor of poor survival that can serve as an important indicator in survival prediction, risk stratification and treatment selection. In clinical practice, more attention should be paid to monitoring pretreatment haemoglobin levels among patients with lung cancer.
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Affiliation(s)
- Yaqi Huang
- School of Nursing, Tianjin Medical University, Tianjin, 300070, China
| | - Siqi Wei
- School of Nursing, Tianjin Medical University, Tianjin, 300070, China
| | - Nan Jiang
- School of Nursing, Tianjin Medical University, Tianjin, 300070, China
| | - Lijuan Zhang
- School of Nursing, Liaoning University of Traditional Chinese Medicine, Liaoning, China
| | - Siyuan Wang
- School of Nursing, Tianjin Medical University, Tianjin, 300070, China
| | - Xiaona Cao
- School of Nursing, Tianjin Medical University, Tianjin, 300070, China
| | - Yue Zhao
- School of Nursing, Tianjin Medical University, Tianjin, 300070, China.
| | - Peiguo Wang
- Department of Radiotherapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, 300060, China.
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