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Linezolid is safe on platelet count for AML patients during myelosuppression after consolidation chemotherapy
De Zhou1, Ting Shi1, Shuqi Zhao1
1Department of Hematology, The First Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, P.R. China.
Background:
Patients with acute myeloid leukaemia (AML) often develop severe infections during myelosuppression after chemotherapy. Linezolid is an appropriate choice for these patients when coverage of positive bacteria is needed. An important side effect of linezolid is linezolid-induced thrombocytopenia; so, the safety of linezolid for AML patients in myelosuppression is of concern. No study has focused on platelets in these patients.
Methods:
We reviewed 1356 AML patients who received consolidation chemotherapy in our hospital during January 2009 and June 2019. Among them, 36 patients were treated with linezolid and 41 with vancomycin. We counted the days of platelet count <20*10E9/L, <50*10E9/L, the lowest platelet count, total quantity of platelet transfusion and clinical bleeding events of these patients, to evaluate the safety of linezolid during myelosuppression in AML patients.
Results:
The days of platelet count <20*10E9/L in the linezolid group and vancomycin group were 6.2 ± 2.5 days and 6.7 ± 2.9 days, and the days of platelet count <50*10E9/L in the linezolid group and vancomycin group were 10.9 ± 3.6 days and 11.7 ± 4.0 days, respectively; there was no significant difference between the two groups. No life-threatening severe bleeding events occurred in either group.
Conclusion:
This retrospective clinical study suggests that it is safe to manage AML patients in complete remission during myelosuppression after standard consolidation chemotherapy with idarubicin and cytarabine, with about 7 days of linezolid therapy.
Insights
Linezolid is safe for acute myeloid leukemia (AML) patients during chemotherapy-induced myelosuppression. This study found no significant difference in platelet counts or bleeding events compared to vancomycin.
Area of Science:
- Hematology
- Oncology
- Infectious Diseases
Background:
- Acute myeloid leukemia (AML) patients undergoing chemotherapy experience myelosuppression, increasing infection risk.
- Linezolid is used for Gram-positive bacterial coverage in AML patients but has potential for thrombocytopenia.
- The safety of linezolid concerning platelet counts in AML patients during myelosuppression remains understudied.
Purpose of the Study:
- To evaluate the safety of linezolid in comparison to vancomycin regarding platelet counts and bleeding events in AML patients during myelosuppression.
- To assess the impact of linezolid therapy on platelet levels in AML patients undergoing consolidation chemotherapy.
Main Methods:
- Retrospective review of 1356 AML patients receiving consolidation chemotherapy between January 2009 and June 2019.
- Comparison of 36 patients treated with linezolid versus 41 patients treated with vancomycin.
- Analysis of days with platelet counts <20*10^9/L and <50*10^9/L, lowest platelet count, platelet transfusion requirements, and clinical bleeding events.
Main Results:
- No significant difference was observed in the duration of platelet counts <20*10^9/L (6.2 vs. 6.7 days) or <50*10^9/L (10.9 vs. 11.7 days) between the linezolid and vancomycin groups.
- Lowest platelet counts and total platelet transfusion quantities were comparable between the two treatment groups.
- No life-threatening severe bleeding events occurred in either the linezolid or vancomycin group.
Conclusions:
- Linezolid therapy appears safe for managing AML patients in complete remission during myelosuppression following standard consolidation chemotherapy.
- Approximately 7 days of linezolid therapy did not lead to significantly worse platelet outcomes or increased bleeding risk compared to vancomycin.
- Further prospective studies may be warranted to confirm these findings in a larger AML patient cohort.
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