2020 Volume 46 Issue 11 Pages 647-654
The use of docetaxel as the primary treatment for metastatic castration-resistant prostate cancer is frequently associated not only with neutropenia but also liver dysfunction. Neutropenia in most patients is usually accompanied by liver dysfunction, but the relationship between the two disorders is unclear. In this study, by analyzing the alanine aminotransferase (ALT) levels of 60 patients who received initial docetaxel therapy, the relationship between grade 4 neutropenia and liver function was investigated. With regard to neutropenia, 31 patients developed grade 4 and 29 developed grade 0 - 3, with mean ALT levels of 34.1 ± 26.6 U/L and 22.3 ± 11.7 U/L, respectively. ALT levels were higher in grade 4 neutropenia than grade 0 - 3 neutropenia. The increase in ALT was negatively correlated with the decrease in neutrophil count. In the grade 4 neutropenia group, the mean ALT level before docetaxel treatment and the previous nadir neutrophil count significantly increased from 19.5 ± 7.4 U/L to 30.1 ± 19.5 U/L. Furthermore, between the two groups, ALT fluctuation was significantly greater in the grade 4 neutropenia group. The observed fluctuations in ALT after docetaxel administration were important, as patients with elevated ALT had a high incidence of grade 4 neutropenia after administration; thus, careful monitoring of the neutrophil count may be required.
