Cancer Res Treat.  2016 Jul;48(3):990-997. 10.4143/crt.2015.296.

Splenomegaly and Its Associations with Genetic Polymorphisms and Treatment Outcome in Colorectal Cancer Patients Treated with Adjuvant FOLFOX

• Kim MJ
• Han SW
• Lee DW
• Cha Y
• Lee KH
• Kim TY
• Oh DY
• Kim SH
• Im SA
• Bang YJ
• Kim TY

• KMID: 2344072
• DOI: http://doi.org/10.4143/crt.2015.296

Abstract

PURPOSE
Splenomegaly is a clinical surrogate of oxaliplatin-induced sinusoidal obstruction syndrome (SOS). We investigated development of splenomegaly and its association with treatment outcome and genetic polymorphisms following adjuvant 5-fluorouracil, leucovorin, and oxaliplatin (FOLFOX) in colorectal cancer (CRC) patients.
MATERIALS AND METHODS
Splenomegaly was determined by spleen volumetry using computed tomography images obtained before initiation of chemotherapy and after completion of adjuvant FOLFOX in CRC patients. Ten genetic polymorphisms in 4 SOS-related genes (VEGFA, MMP9, NOS3, and GSTP1) were analyzed using DNA from peripheral blood mononuclear cells.
RESULTS
Of 124 patients included, increase in spleen size was observed in 109 (87.9%). Median change was 31% (range, -42% to 168%). Patients with splenomegaly had more severe thrombocytopenia compared to patients without splenomegaly during the chemotherapy period (p < 0.0001). The cumulative dose of oxaliplatin and the lowest platelet count during the chemotherapy period were clinical factors associated with splenomegaly. However, no significant associations were found between genetic polymorphisms and development of splenomegaly. Disease-free survival was similar regardless of the development of splenomegaly.
CONCLUSION
Splenomegaly was frequently observed in patients receiving adjuvant FOLFOX and resulted in more severe thrombocytopenia but did not influence treatment outcome. Examined genetic polymorphisms did not predict development of splenomegaly.

Keyword

Colorectal neoplasms; Oxaliplatin; Sinusoidal obstruction syndrome; Splenomegaly; Genetic polymorphism

MeSH Terms

Colorectal Neoplasms*
Disease-Free Survival
DNA
Drug Therapy
Fluorouracil
Hepatic Veno-Occlusive Disease
Humans
Leucovorin
Platelet Count
Polymorphism, Genetic*
Spleen
Splenomegaly*
Thrombocytopenia
Treatment Outcome*
DNA
Fluorouracil
Leucovorin

Figure

• 

  Fig. 1. Changes in platelet counts during or after chemotherapy in patients with or without splenomegaly. FOLFOX, 5-fluorouracil, leucovorin, and oxaliplatin. *p < 0.05, **p < 0.01.

• 

  Fig. 2. Kaplan-Meier survival curve of disease-free survival according to the development of splenomegaly

Reference

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