Macrocytosis as a potential parameter associated with survival after tyrosine kinase inhibitor treatment

Publication date: March 2016
Source:European Journal of Cancer, Volume 56
Author(s): Jacqueline S.L. Kloth, Paul Hamberg, Pauline A.J. Mendelaar, Roderick R. Dulfer, Bronno van der Holt, Karel Eechoute, Erik A.C. Wiemer, Wim H.J. Kruit, Stefan Sleijfer, Ron H.J. Mathijssen
Aim of the studyAs a rise in mean corpuscular volume (MCV) of the erythrocyte is frequently seen during treatment with imatinib and sunitinib, we investigated whether macrocytosis (MCV > 100 fl) also occurs as a class effect in other tyrosine kinase inhibitors (TKIs) and whether occurrence of macrocytosis is associated with outcome.Materials and methodsIn 533 patients, using 5 TKIs, we investigated if macrocytosis and an increase in MCV were associated with progression-free survival and overall survival (OS) in specific tumour-treatment combinations.ResultsMacrocytosis as well as an increase in MCV from baseline of >10 fl (ΔMCV +10 fl), when included as a time-dependent covariate, were associated with improved OS in patients with renal cell cancer (RCC) treated with sunitinib (macrocytosis, hazard ratio [HR] = 0.61, p = 0.031, and ΔMCV +10 fl, HR = 0.58, p = 0.016).ConclusionIn sunitinib-treated patients with RCC, the occurrence of macrocytosis, or a substantial increase in MCV levels after start of treatment, could potentially serve as a positive prognostic factor for survival, if validated prospectively.



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