Evaluating hematologic parameters in newly diagnosed and recurrent glioblastoma: Prognostic utility and clinical trial implications of myelosuppression Article Swipe
Davy Deng
,
Lubna Hammoudeh
,
Gilbert Youssef
,
Yu‐Hui Chen
,
Kee‐Young Shin
,
Mary Jane Lim-Fat
,
J Ricardo McFaline-Figueroa
,
Ugonma Chukwueke
,
Shyam Tanguturi
,
David A. Reardon
,
Eudocia Q. Lee
,
Lakshmi Nayak
,
Wenya Linda Bi
,
Omar Arnaout
,
Keith L. Ligon
,
Patrick Y. Wen
,
Rifaquat Rahman
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1093/noajnl/vdad083
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1093/noajnl/vdad083
Background Glioblastoma (GBM) patients are treated with radiation therapy, chemotherapy, and corticosteroids, which can cause myelosuppression. To understand the relative prognostic utility of blood-based biomarkers in GBM and its implications for clinical trial design, we examined the incidence, predictors, and prognostic value of lymphopenia, neutrophil-to-lymphocyte ratio (NLR), and platelet count during chemoradiation (CRT) and recurrence. Methods This cohort study included 764 newly diagnosed glioblastoma patients treated from 2005 to 2019 with blood counts prior to surgery, within 6 weeks of CRT, and at first recurrence available for automatic extraction from the medical record. Logistic regression was used to evaluate exposures and Kaplan–Meier was used to evaluate outcomes. Results Among the cohort, median age was 60.3 years; 87% had Karnofsky performance status ≥ 70, 37.5% had gross total resection, and 90% received temozolomide (TMZ). During CRT, 37.8% (248/656) of patients developed grade 3 or higher lymphopenia. On multivariable analysis (MVA), high NLR during CRT remained an independent predictor for inferior survival (Adjusted Hazard Ratio [AHR] = 1.57, 95% CI = 1.14–2.15) and shorter progression-free survival (AHR = 1.42, 95% CI = 1.05–1.90). Steroid use was associated with lymphopenia (OR = 2.66,1.20–6.00) and high NLR (OR = 3.54,2.08–6.11). Female sex was associated with lymphopenia (OR = 2.33,1.03–5.33). At first recurrence, 28% of patients exhibited grade 3 or higher lymphopenia. High NLR at recurrence was associated with worse subsequent survival on MVA (AHR = 1.69, 95% CI = 1.25–2.27). Conclusions High NLR is associated with worse outcomes in newly diagnosed and recurrent glioblastoma. Appropriate eligibility criteria and accounting and reporting of blood-based biomarkers are important in the design and interpretation of newly diagnosed and recurrent glioblastoma trials.
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- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1093/noajnl/vdad083
- https://academic.oup.com/noa/advance-article-pdf/doi/10.1093/noajnl/vdad083/50840494/vdad083.pdf
- OA Status
- gold
- Cited By
- 7
- References
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- Related Works
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- OpenAlex ID
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All OpenAlex metadata
Raw OpenAlex JSON
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https://openalex.org/W4383501054Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1093/noajnl/vdad083Digital Object Identifier
- Title
-
Evaluating hematologic parameters in newly diagnosed and recurrent glioblastoma: Prognostic utility and clinical trial implications of myelosuppressionWork title
- Type
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articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2023Year of publication
- Publication date
-
2023-01-01Full publication date if available
- Authors
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Davy Deng, Lubna Hammoudeh, Gilbert Youssef, Yu‐Hui Chen, Kee‐Young Shin, Mary Jane Lim-Fat, J Ricardo McFaline-Figueroa, Ugonma Chukwueke, Shyam Tanguturi, David A. Reardon, Eudocia Q. Lee, Lakshmi Nayak, Wenya Linda Bi, Omar Arnaout, Keith L. Ligon, Patrick Y. Wen, Rifaquat RahmanList of authors in order
- Landing page
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https://doi.org/10.1093/noajnl/vdad083Publisher landing page
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https://academic.oup.com/noa/advance-article-pdf/doi/10.1093/noajnl/vdad083/50840494/vdad083.pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
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https://academic.oup.com/noa/advance-article-pdf/doi/10.1093/noajnl/vdad083/50840494/vdad083.pdfDirect OA link when available
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Medicine, Internal medicine, Temozolomide, Hazard ratio, Cohort, Oncology, Incidence (geometry), Chemotherapy, Proportional hazards model, Gastroenterology, Surgery, Confidence interval, Physics, OpticsTop concepts (fields/topics) attached by OpenAlex
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7Total citation count in OpenAlex
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2025: 2, 2024: 5Per-year citation counts (last 5 years)
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47Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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