Risk Factors of Hematological Toxicity of Mesothelioma Treatment-A Territory-Wide Retrospective Study

While chemotherapy remains the treatment of choice for mesothelioma, it carries significant toxicities, especially hematological toxicity.

We conducted this territory-wide retrospective study in Hong Kong to investigate the prevalence and risk factors of hematological toxicity associated with mesothelioma treatment.

A total of 222 patients were included in the analysis. Lower baseline serum albumin level and more lines of cytotoxic chemotherapy received were risk factors for developing grade 3-4 hematological toxicity with aOR of 1.05 (95% CI, 1.02-1.09, p = 0.003) and 1.50 (95% CI, 1.03-2.19, p = 0.033) respectively. Risk factors for developing neutropenic fever included: diabetes mellitus (aOR = 9.44, 95% CI, 2.59-34.45, p < 0.001); the use of chemotherapy other than pemetrexed (aOR = 4.80, 95% CI, 1.05-21.89, p = 0.043); the presence of third-space fluid (aOR = 3.58, 95% CI, 1.16-11.05, p = 0.027), pleural effusion (aOR = 4.20, 95% CI, 1.34-13.17, p = 0.014) and pericardial effusion (aOR = 7.97, 95% CI, 1.18-53.93, p = 0.033). Number of lines of cytotoxic chemotherapy the patients received was the risk factor for pack cell transfusion with aOR of 2.35 (95% CI, 1.54-3.60, p < 0.001).

Hematological toxicities were commonly seen in the treatment course of mesothelioma. Risk factors include disease factors and treatment factors. Use of ICI could bring about hope in reducing the risk of hematological toxicities.