ArticleNeuro-oncology2022
Prognostic significance of therapy-induced myelosuppression in newly diagnosed glioblastoma.
Article in Neuro-oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed, 30 citations in OpenAlex.
- Patterns, predictors and prognostic relevance of high-grade hematotoxicity after temozolomide or temozolomide-lomustine in the CeTeG/NOA-09 trial.Journal of neuro-oncology · 2023Trial
- Prognostic associations of steroid use in patients with glioblastoma: A population-based study.Neuro-oncology practice · 2026Article
- Glioblastoma treatment patterns and outcomes over 18 years in an Irish cancer centre.Irish journal of medical science · 2026Article
- Peripheral hematological landscapes as biomarkers for detecting postoperative progression in glioblastoma multiforme: a multivariable risk scoring approach.Journal of neuro-oncology · 2026Article
- Article
- CXCR5Nature communications · 2026Article
- Mismatch repair deficiency drives malignant progression and alters the tumor immune microenvironment in glioblastoma models.The Journal of clinical investigation · 2026Article
- Targeting immunosuppressive network in glioblastoma: Emerging strategies to overcome immunodeficiency and enhance therapeutic efficacy.Acta pharmaceutica Sinica. B · 2026Review
- Recurrent hematological toxicity after second-line treatment in patients with glioblastoma: indication of a potential predisposition.The oncologist · 2026Article
- Mechanism of Babao Dan on fluorouracil-induced bone marrow suppression and T cell immune disorder through MAPK pathway.Scientific reports · 2026Article
- Severe temozolomide-induced thrombocytopenia is linked to increased healthcare utilization in glioblastoma and disproportionally impacts female patients.Neuro-oncology practice · 2025Article
- Peripheral biomarkers predict survival in patients with glioblastoma treated with temozolomide.Molecular and clinical oncology · 2025Article
- Understanding the Immune System and Biospecimen-Based Response in Glioblastoma: A Practical Guide to Utilizing Signal Redundancy for Biomarker and Immune Signature Discovery.Current oncology (Toronto, Ont.) · 2024Review
- Towards Effective Treatment of Glioblastoma: The Role of Combination Therapies and the Potential of Phytotherapy and Micotherapy.Current issues in molecular biology · 2024Review
- Regulatory mechanisms of PD-1/PD-L1 in cancers.Molecular cancer · 2024Review
- The need for paradigm shift: prognostic significance and implications of standard therapy-related systemic immunosuppression in glioblastoma for immunotherapy and oncolytic virotherapy.Frontiers in immunology · 2024Review
- Prolonged use of temozolomide leads to increased anxiety and decreased content of aggrecan and chondroitin sulfate in brain tissues of aged rats.Biomedical reports · 2024Article
- Systemic and local immunosuppression in glioblastoma and its prognostic significance.Frontiers in immunology · 2024Review
- Diagnosis and management of complications from the treatment of primary central nervous system tumors in adults.Neuro-oncology · 2023Article
- Imaging biomarkers for clinical applications in neuro-oncology: current status and future perspectives.Biomarker research · 2023Review
Corrections and comments
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Authors and funding
10 authors at 7 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMyelosuppression is the major toxicity encountered during temozolomide chemoradiotherapy for newly diagnosed glioblastoma.
methodsWe assessed the association of myelosuppression (neutropenia, thrombocytopenia, anemia, and lymphopenia) during temozolomide chemoradiotherapy alone or in combination with experimental agents with progression-free survival (PFS) or overall survival (OS) in 2073 patients with newly diagnosed glioblastoma enrolled into five clinical trials: CENTRIC, CORE, EORTC 26082, AVAglio, and EORTC 26981. A landmark Cox model was used. For each primary association analysis, a significance level of 1.7% was used.
resultsLower neutrophil counts at baseline were associated with better PFS (P = .011) and OS (P < .001), independently of steroid intake. Females experienced uniformly more myelotoxicity than males. Lymphopenia during concomitant chemoradiotherapy was associated with OS (P = .009): low-grade (1-2) lymphopenia might be associated with superior OS (HR 0.78, 98.3% CI 0.58-1.06), whereas high-grade (3-4) lymphopenia might be associated with inferior OS (HR 1.08, 98.3% CI 0.75-1.54). There were no associations of altered hematological parameters during concomitant chemoradiotherapy with PFS. During maintenance chemoradiotherapy, no significant association was found between any parameter of myelosuppression and PFS or OS, although exploratory analysis at 5% significance level indicated that either mild-to-moderate (HR 0.76, 95% CI 0.62-0.93) or high-grade lymphopenia (HR 0.65, 95% CI 0.46-0.92) was associated with superior OS (P = .013), but not PFS.
conclusionsThe association of higher neutrophil counts at baseline with inferior PFS and OS requires further prospective evaluation. The link of therapy-induced lymphopenia to better outcome may guide the design for immunotherapy trials in newly diagnosed glioblastoma.
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