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347 Risk factors of bone marrow toxicities in ovarian cancer patients treated with parp inhibitors
  1. Mikolaj Piotr Zaborowski1,
  2. Cezary Miedziarek1,
  3. Aleksandra Gladych-Macioszek2 and
  4. Ewa Nowak-Markwitz1
  1. 1Division of Gynaecological Oncology, Department of Gynaecology, Poznan University of Medical Sciences, Poznan, Poland, Poznan, Poland
  2. 2Poznan University of Medical Sciences, Poznan, Poland, Poznan, Poland


Introduction/Background PARP inhibitors significantly improve the prognosis of ovarian cancer patients. The study aimed to analyze the hematological side effects during maintenance therapy with olaparib and niraparib in ovarian cancer.

Methodology The epidemiological and clinical data of 68 patients (34 in the niraparib group and 34 in the olaparib group) were collected during weekly or monthly follow-ups, respectively. The dynamics of platelets (PLT), neutrophils (NEU), and hemoglobin (HB) concentrations were analyzed. The hematological complications of grade 3 or 4, according to Common Terminology Criteria for Adverse Events v5.0, were defined as severe.

Results Niraparib treatment was predominantly related to PLT decrease. Any thrombocytopenia occurred in 25 (73.53%) patients. Severe thrombocytopenia occurred in 9 (26.47%) subjects. The lowest PLT count was in the 4th week of treatment. Patients with higher pre-treatment PLT count and initial HE4 concentration had a more significant PLT drop rate. Patients with greater NEU and PLT drop during therapy, longer intervals between chemotherapy and PARPi therapy, higher initial HE4, and lower body weight were at higher risk of severe thrombocytopenia.

Olaparib treatment was mainly related to HB decrease. Any anemia occurred in 21 (61,77%) subjects. Severe anemia occurred in 7 (20.59%) patients. The lowest HB concentration was in the 3rd month of treatment. The higher BMI was correlated with a more significant HB concentration drop rate in this group. Severe anemia more often occurred in patients with more pronounced initial HB drop and higher BMI.

Conclusion The following factors affect the risk of severe hematological side effects during PARPi therapy: 1) the higher rate of decrease in PLT, NEU, and HB; 2) higher pre-treatment HE4; 3) longer interval between chemotherapy and PARPi therapy; and 4) BMI.

Disclosures The authors declare that they have no relevant or material financial interests that relate to the research described in this paper.

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