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- Title
Impact of Age on Poly(ADP-Ribose) Polymerase Inhibitor (PARPi)-Induced Lymphopenia: A Scoping Review of the Literature and Internal Analysis of a Retrospective Database.
- Authors
Antherieu, Gabriel; Heiblig, Maël; Freyer, Gilles; Ghesquieres, Hervé; Falandry, Claire
- Abstract
Background: Poly(ADP-ribose) polymerase inhibitors (PARPi) are increasingly used in oncology; their hematological toxicities affect classically red, platelet and neutrophil lineages, but some opportunistic infections have been reported concomitantly to deep lymphopenias. Objective: This study was designed to provide an external and internal analysis of the crossed impacts of PARPi and age on lymphopenia risk. Patients and Methods: A scoping review was performed on the PubMed and Embase databases to assess the reporting of lymphocyte rates in original studies on PARPi treatment for adult patients up to 1 April 2022. A retrospective cohort was extracted from the medical charts of all patients treated for gynecological cancer at our institution from 2015 to 2022 in accordance with ethical regulations. Results: The scoping review research strategy retrieved 5840 abstracts; 225 studies were selected for full-text analysis. Lymphopenia was reported in 41.8% of the studies; frequency of all-grade and grade ≥ 3 lymphopenia reached 20.5% and 8.9%, respectively. Grade ≥ 3 lymphopenia was significantly higher in studies including older patients (median age ≥ 60 years vs. < 60 years), at 7.5% vs. 10.3% (p < 0.0001). PARIB-OLD-HCL included 46 patients, 19 of whom were aged < 70 years (median 44 years) and 27 of whom were aged ≥ 70 years (median 79 years); the frequency of all-grade and grade ≥ 3 lymphopenia reached 67% (< 70 years: 63%; ≥ 70 years: 70%) and 13% (< 70 years: 5%; ≥ 70 years: 19%), respectively. Conclusion: Lymphopenia events were much more frequent in real-life than in previously reported studies, particularly in older patients. Future work is needed to improve patient follow-up and discuss prophylactic strategies.
- Subjects
ONLINE information services; MEDICAL information storage &; retrieval systems; AGE distribution; SYSTEMATIC reviews; ANTINEOPLASTIC agents; RETROSPECTIVE studies; ACQUISITION of data; FISHER exact test; LYMPHOPENIA; RISK assessment; SEVERITY of illness index; COMPARATIVE studies; TRANSFERASES; MEDICAL records; CHI-squared test; DESCRIPTIVE statistics; TUMORS; LITERATURE reviews; MEDLINE; DATA analysis software; ENZYME inhibitors; LYMPHOCYTE count; FEMALE reproductive organ tumors; DISEASE risk factors; EVALUATION
- Publication
Drugs & Aging, 2023, Vol 40, Issue 5, p397
- ISSN
1170-229X
- Publication type
Article
- DOI
10.1007/s40266-023-01023-7