Urinary Neopterin, Hemoglobin and Peripheral Blood Cell Counts in Breast Carcinoma Patients Treated with Dose-dense Chemotherapy

• Published in: Anticancer research Vol. 28; no. 4C; pp. 2389 - 2396
• Main Authors: MELICHAR, Bohuslav, URBANEK, Lubor, KRCMOVA, Lenka, KALABOVA, Hana, MELICHAROVA, Karolina, MALIROVA, Eva, HORNYCHOVA, Helena, RYSKA, Ales, HYSPLER, Radomir, SOLICHOVA, Dagmar
• Format: Journal Article
• Language: English
• Published: Attiki International Institute of Anticancer Research 01-07-2008
• Subjects: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Blood Cell Count; Breast Neoplasms - blood; Breast Neoplasms - drug therapy; Breast Neoplasms - metabolism; Breast Neoplasms - urine; Breast Neoplasms, Male - blood; Breast Neoplasms, Male - drug therapy; Breast Neoplasms, Male - urine; Chemotherapy, Adjuvant; Cyclophosphamide - administration & dosage; Dose-Response Relationship, Drug; Doxorubicin - administration & dosage; Female; Ferritins - blood; Gynecology. Andrology. Obstetrics; Hemoglobins - metabolism; Humans; Male; Mammary gland diseases; Medical sciences; Middle Aged; Neoadjuvant Therapy; Neopterin - urine; Paclitaxel - administration & dosage; Tumors; Antineoplastic agent; Breast disease; Ferritin; Iron; Doxorubicin; Breast carcinoma; Isomerases; Cancerology; Taxane derivatives; Paclitaxel; Hemoglobin; Antimitotic; High dose; Human; DNA topoisomerase (ATP-hydrolysing); Enzyme; Enzyme inhibitor; Breast cancer; Topoisomerase II inhibitor; Malignant tumor; Mammary gland diseases; Alkylating agent; Oxazaphosphinane derivatives; Chemotherapy; Cyclophosphamide; Treatment; Nitrogen mustard; Anthracyclins; Neopterin; Blood cell count; Cancer
• ISSN: 0250-7005; 1791-7530

Background: Among other actions, chemotherapy may induce an activation of systemic inflammatory and immune response. Patients
and Methods: Urinary neopterin was evaluated, using high-performance liquid chromatography, before and during dose-dense combination
chemotherapy with doxorubicin, cyclophosphamide and sequential paclitaxel (neoadjuvant or adjuvant) in 194 patients with breast
carcinoma. Hemoglobin, peripheral blood cell count and, in a subgroup of patients, iron metabolism were also evaluated. Results:
Urinary neopterin increased significantly during the chemotherapy. The increase in urinary neopterin was accompanied by a
gradual decrease of hemoglobin. A marked increase in serum ferritin concentration was observed during the chemotherapy, along
with fluctuations of iron concentrations. Among 161 patients treated with primary chemotherapy, the pathological response
was evaluable in 150. Pathological complete response was observed in 37 cases (25%). In patients with pathological complete
response, significantly lower serum ferritin concentrations were observed. Conclusion: Present data demonstrate the presence
of systemic immune activation, reflected in increased urinary neopterin concentrations, in breast carcinoma patients treated
with dose-dense chemotherapy. Lower ferritin concentrations were predictive of pathological complete response.