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Severe temozolomide-induced thrombocytopenia is linked to increased healthcare utilization in glioblastoma and disproportionally impacts female patients

Title: Severe temozolomide-induced thrombocytopenia is linked to increased healthcare utilization in glioblastoma and disproportionally impacts female patients
Authors: van Hout, Leon; Borgo, Alessia D.; Grun, Nienke; Schuur, Maaike; Broen, Martijn P. G.; Westerman, Bart A.; Bartelink, Imke; Vandertop, William Peter; Witte, Birgit; Kouwenhoven, Mathilde C. M.
Source: van Hout, L, Borgo, A D, Grun, N, Schuur, M, Broen, M P G, Westerman, B A, Bartelink, I, Vandertop, W P, Witte, B & Kouwenhoven, M C M 2025, 'Severe temozolomide-induced thrombocytopenia is linked to increased healthcare utilization in glioblastoma and disproportionally impacts female patients', Neuro-Oncology Practice, vol. 12, no. 4, npaf013, pp. 678-690. https://doi.org/10.1093/nop/npaf013
Publication Year: 2025
Collection: Maastricht University Research Publications
Subject Terms: ADJUVANT TEMOZOLOMIDE; CANCER-PATIENTS; CONCOMITANT; COST; ECONOMIC BURDEN; TOXICITY; glioblastoma; healthcare utilization; temozolomide; thrombocytopenia
Description: Background. Thrombocytopenia is a major temozolomide-induced adverse event during the standard treatment of glioblastoma. Consequently, platelet transfusions and treatment modifications may impact quality of life and long-term treatment outcomes. Understanding the impact of thrombocytopenia on healthcare utilization is crucial to mitigate the need for healthcare resources in glioblastoma patients. Here, we assess the influence of thrombocytopenia-related healthcare among patients diagnosed with glioblastoma. Methods. We retrospectively collected patient information treated at the BrainTumor Center Amsterdam between 2008 and 2021.The occurrence of thrombocytopenia, patient demographics, treatment details, and healthcare utilization data were gathered from patients who received standard glioblastoma treatment. Associations between temporal severity of thrombocytopenia as categorized by the Common Terminology Criteria for Adverse Events, patient characteristics, and healthcare utilization were analyzed using Generalized Linear Mixed Models. Results. We included 206 patients with a median age of 58 years, 35.9% were female and we found that thrombocytopenia (any grade) occurred in 61.1% of patients.The occurrence of thrombocytopenia during CRT was associated with increased healthcare utilization and was largest in females who developed grade 4 thrombocytopenia compared to those who did not develop thrombocytopenia (OR = 5.9, P < .001 in females vs OR = 4.4, P < .001 in males). Grade 4 thrombocytopenia was also associated with heightened healthcare utilization during the adjuvant phase (OR = 7.6, P < .001), and was comparable between sexes. Conclusions. Severe thrombocytopenia during glioblastoma treatment is linked to increased healthcare utilization, disproportionally impacting females.These data suggest that prevention and early management of thrombocytopenia can reduce healthcare utilization in patients with glioblastoma.
Document Type: article in journal/newspaper
Language: English
ISSN: 2054-2585
Relation: info:eu-repo/semantics/altIdentifier/wos/001439800300001; info:eu-repo/semantics/altIdentifier/pissn/2054-2585
DOI: 10.1093/nop/npaf013
Availability: https://cris.maastrichtuniversity.nl/en/publications/8c3c3a6c-7cc9-45c5-89a3-d12790cd8fbd; https://doi.org/10.1093/nop/npaf013
Rights: info:eu-repo/semantics/openAccess ; http://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.96DD2AF0
Database: BASE