Ho Gak Kim
Catholic University of Daegu, Korea
Title: The increment of platelet count is a risk factor of pulmonary thromboembolism in patients with pancreatic cancer treated with gemcitabine
Biography
Biography: Ho Gak Kim
Abstract
Introduction: Pancreatic cancer is among the most common cancers associated with pulmonary thromboembolism (PTE). Moreover, PTE has developed in patients with thrombocytopenia as well as thrombocytosis during gemcitabine-based chemotherapy. Aim: The present study was aimed to determine the change of platelet count and the associated risk of PTE. Methods: A retrospective 1:2 matched cohort study was performed to evaluate the risk of PTE in patient with gemcitabine-based chemotherapy for pancreatic cancer. Clinical parameter including rate of increment of platelet count (Inc-Plt) was checked in PTE group and non-PTE group. Inc-Plt was defined as the difference of platelet count from new cycle day 1 to last cycle day 15. The rate of Inc-Plt was defined as the rate of increased platelet count at new cycle day 1 compared with previous cycle day 15. Each patient in PTE group was matched with two patients in the non-PTE group. Inc-Plt = Platelet count at new cycle D1 ˗ Platelet count at last cycle D15 Rate of Inc ˗ Plt = Platelet count at new cycle D1 ˗ Platelet count at last cycle D15 Platelet count at last cycle D15 Results: From January 2010 to March 2015, 12 patients (9.1%) were diagnosed PTE during chemotherapy (PTE group) among 132 patients who received gemcitabine-based chemotherapy and 24 patients who did not have PTE were matched in non-PTE group. Age, sex proportion, body mass index, presence of metastasis, gemcitabine amount, previous anti-platelet agent medication, Karnofsky performance scale were not different significantly between two groups. The average Inc-Plt was 123,649±109,864/µl in PTE group and 141,978±129,846/µl in non-PTE group (p=0.42). The average rate of Inc-Plt was significantly higher in PTE group (32.1% in PTE group vs. 20.4% in non-PTE group, p=0.033). The average rate of Inc-Plt more than 30% was observed more frequently in PTE group (4.3±1.6 in PTE group vs. 2.1±1.8 in non-PTE group, p=0.039). Conclusion: The incidence of PTE was 9.1% during gemcitabine-based chemotherapy in pancreas cancer. The increment of platelet count and high level of platelet during chemotherapy are the risk of PTE.