Immature and absolute platelet count changes and thrombocytopenia in malignant glioma

Authors

  • Matthias Preusser,

    1. Department of Medicine I, Medical University of Vienna, Vienna, Austria
    2. Comprehensive Cancer Center – Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, Austria
    Search for more papers by this author
  • Katarzyna Elandt,

    1. Department of Medicine I, Medical University of Vienna, Vienna, Austria
    Search for more papers by this author
  • Ilse Schwarzinger,

    1. Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
    Search for more papers by this author
  • Christine Marosi,

    1. Department of Medicine I, Medical University of Vienna, Vienna, Austria
    2. Comprehensive Cancer Center – Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, Austria
    Search for more papers by this author
  • Harald Heinzl

    1. Comprehensive Cancer Center – Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, Austria
    2. Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria
    Search for more papers by this author

Matthias Preusser, MD, Department of Medicine I and Comprehensive Cancer Center – Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria. Tel.: 00431-40400-4457; fax: 00431-40400-6088; e-mail: matthias.preusser@meduniwien.ac.at

Abstract

Eur J Clin Invest 2011; 41 (5): 539–545

Abstract

Background  Temozolomide (TMZ) is commonly used for the therapy of malignant glioma and induces thrombocytopenia in a fraction of patients. Currently, no biomarkers predicting TMZ-induced thrombocytopenia are available. In this study, we investigated whether changes in platelet count (PLT) or the immature platelet fraction (IPF) may serve as predictor of TMZ-induced thrombocytopenia in malignant glioma patients.

Methods  We prospectively included 52 malignant glioma patients receiving TMZ-containing therapy regimens in this study. Platelet counts and IPF were determined at each clinical follow-up visit (weekly during concomitant radiochemotherapy or at least monthly during TMZ monotherapy) using the Sysmex XE-2100 system. We explored the diagnostic utility of PLT change/day and IPF change/day from the last to the current follow-up visit for the prediction of clinically relevant thrombocytopenia (PLT < 100·000 μl−1) at the next follow-up visit.

Results  Relevant thrombocytopenia was observed in 10 of 234 occasions. The areas under the receiver operating characteristic curves for PLT absolute change/day, PLT relative change/day and IPF relative change/day were 0·675, 0·703 and 0·663, respectively. The Youden indices (maximum sum of sensitivity and specificity minus one) were 0·31, 0·39, and 0·29, respectively. The corresponding positive predictive values were 16%, 57%, and 6·7%, and the negative predictive values were 97%, 97%, and 98%, respectively.

Conclusions  The rather moderate diagnostic potential of our data indicate that the time course of PLT counts and IPF measured at routine clinical follow-up are not useful for the prediction of thrombocytopenia in glioma patients treated with TMZ.

Ancillary