2025, Vol. 7, Issue 3, Part B

Author(s): Sarah Hamed Abd Alsaheb and Sajid Jabbar Hasan

Abstract: Background: Carboplatin is a platinum-based chemotherapy commonly used for lung cancer treatment. Thrombocytopenia is a major dose-limiting side effect, correlated with the area under the concentration curve (AUC). Predictive markers for carboplatin-induced thrombocytopenia could help identify patients who need reduced doses. Thrombocytopenia caused by carboplatin combined with pemetrexed is notably influenced by carboplatin in commonly used regimens for lung cancer. Objectives: Is to detect predictive markers for carboplatin-induced severe thrombocytopenia in patients receiving carboplatin plus pemetrexed therapy Methods: A prospective cohort study was conducted at the Oncology Teaching Hospital Medical Complex in Baghdad, Iraq. The study included 50 Iraqi patients diagnosed with lung adenocarcinoma between May 2022 and January 2023. Data were collected prospectively from the hospital's laboratory and directly from participants during their regular visits to the consultation room. Results: Fifty patients with lung adenocarcinoma were included in this prospective cohort study. the mean age of the samples was 61.1 ± 11.2 years old. The proportion of males was 66% and for females was 34%. A thirty percent of the patients had a history of smoking. Regarding co-morbidities hypertension was the most common co-morbidity found with a prevalence of 14% followed by diabetes and heart failure. None of the cases had a family history of lung cancer The incidence of ? Grade I thrombocytopenia after carboplatin Plus pemetrexed treatment in this dataset was reported to be 24%. 28 patients had N/L ratio > 3 prior to chemotherapy initiation and it was reduced to 40% after treatment (P-value = 0.08). Platelets count was significantly reduced after cycles of chemotherapy treatment from a median of 322.5 to 246.5 (Wilcoxon test, P-value <0.001). On the other hand, N/L ratio was also reduced from a median of 3.3 to 2.2 though not statistically significant. Conclusion: Pre-treatment platelet count and N/L ratio are potential markers for identifying chemotherapy patients at higher risk of developing thrombocytopenia. Platelet count can predict both the incidence and severity of post-chemotherapy thrombocytopenia, with 258 x 10^9/L identified as the optimal cutoff. However, while the N/L ratio is associated with an increased risk, it was not found to be a reliable predictive factor.

DOI: 10.22271/27069567.2025.v7.i3b.655

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