We observed that each drug had a distinct effect on both the changes in blood cell subpopulations and the underlying genetic architecture of hematotoxicity. We sought to identify genomic loci that influence chemotherapy-induced hematotoxicity by dosing Diversity Outbred mice with one of three chemotherapy drugs doxorubicin, cyclophosphamide or docetaxel. Although clinical factors influence patient responses, genetic factors may also play an important role. Hematotoxicity is a life-threatening side effect of many chemotherapy regimens. This article will review the physiology of the bone marrow, risk factors for cytopenias, and current guidelines and recommendations for prevention and treatment of myeloid toxicity of cancer treatment. Each of these interventions requires familiarity with the risk and benefits of treatment. The AP in oncology is often the primary point of contact for management of cytopenias, including administration of myeloid growth factors, transfusion of blood products, and management of acute events such as neutropenic fevers. Familiarity with factors predictive of high-risk febrile neutropenia, bleeding due to thrombocytopenia, and cardiopulmonary compromise due to anemia will provide the advanced practitioner (AP) in oncology with critical tools for rapid identification of patients at risk, prompt implementation of established guidelines for management, and avoidance of clinical deterioration. Risk factors for myelotoxicity can be broadly categorized into three types: disease-related, host-related, and treatment- related. Myeloid cytopenias, including neutropenia, thrombocytopenia, and anemia, are the most common manifestations of treatment-related myelotoxicity and one of the most common reasons for dose modifications, dose delays, or discontinuation of therapy, potentially limiting therapeutic benefit. Myelotoxicity is one of the most common treatment-related adverse events for patients receiving systemic antineoplastic therapy or radiotherapy to bone marrow-producing regions. Conclusion: Before treatment, weight loss rate is 5% or higher, chemotherapy has a cycle of 3 or more and sub-normal WBC level is independent risk factor of lung cancer after chemotherapy-induced leucopenia. Multivariate analysis revealed that the weight loss rate ≥5% (OR = 0.503), sub-normal pre-WBC level (OR = 11.807), the cycle of chemotherapy ≥3 (OR = 3.100) were main risk factors for CIL in lung cancer. The weight loss rate, PS score, sub-normal pre-WBC level, sub-normal pre-PLT level, and the cycle of chemotherapy were significantly different between the groups (P < 0.05). The demographic data including gender (P = 0.795), age (P = 0.134), presence of selected chronic comorbidities (P = 0.23) were not significantly different in the two groups. Results: Among 358 cases of lung cancer who received chemotherapy, a total of 240 patients experienced CIL, rate was 67%. Methods: A retrospective study was conducted on data from 358 patients with lung cancer who received chemotherapy. Objective: This analysis was conducted to clarify risk factors for chemotherapy-induced leukopenia (CIL) in lung cancer. This article will review the physiology of hematopoiesis, pathophysiology of cytopenias, and current guidelines and recommendations for prevention and treatment of myelotoxicity of cytotoxic chemotherapy. Each of those cytopenias requires separate intervention. It takes place in bone marrow-producing regions causing netropenia, thrombocytopenia and anemia. Myelotoxicity is one of the most common chemotherapy-induced adverse events. Therefore, formidable toxic effect of chemotherapy to normal tissue becomes the main problem, which clinicians should consider. Beside killing the target cells, the cytotoxic compound of cancer drug may also seriously alter normal cells. As most medicines come with side effects, so does chemotherapy. Determinated attempts have been delivered to eliminate cancer with chemotherapy being the most important management strategy for advance stage lung cancer. In Indonesia, it contributes the highest number to cancer incidence in male and is ranked fifth in female cancer incidence. Lung cancer is the leading cause of cancer death in Asia.
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