Early Hematological Toxicity of mFOLFOX6 Therapy and Prognostic Nutritional Index (PNI)

Abstract

  mFOLFOX6 therapy is an adjuvant chemotherapy for colon cancer in which early hematological toxicity causes a need for a reduction in dose intensity. In this study, serum albumin (ALB) levels and prognostic nutritional index (PNI) were measured in four patients who postponed treatment or underwent dose reduction due to hematological toxicity (decreased neutrophil and platelet counts) before the sixth course of mFOLFOX6 therapy (Group A). These were compared to ALB levels and PNI in seven patients who did not reduce or postpone treatment (Group B). Relative dose intensity (RDI), PNI, and ALB levels were significantly decreased in Group A compared with those in Group B, whereas no differences were found between the two groups in terms of weight loss or dietary intake. It is possible that disorders of digestion and absorption resulting from 5-FU-related small intestinal mucosal injury cause decreased PNI levels despite the absence of weight loss or decreased dietary intake. Our results suggest that PNI measurements may predict early hematological toxicity.