Thrombocytopenia associated with second-line carboplatin-based chemotherapy for ovarian, fallopian tube, and primary peritoneal cavity cancers

Purpose: There are limited data available in the oncology literature regarding the risk of thrombocytopenia associated with carboplatin-based second-line treatment of ovarian cancer, outside the setting of patients participating in clinical trials. Methods: To examine this clinically-relevant issue, we conducted a retrospective review of the medical records of women with ovarian cancer treated in the Gynecologic Cancer Program of the Cleveland Clinic from 1994 through November 2003, who received > 2 second-line carboplatin-based regimens. Results: A total of 176 second-line carboplatin-based programs were delivered to the 152 patients ( median age 61 years; range 39 - 87 years) identified through this review. A total of ten (7%) patients experienced > grade 2 thrombocytopenia, with only four (3%) patients developing platelet count nadirs < 50.0 x 10(9)/l. No patient required discontinuation of platinum-based therapy due to the development of thrombocytopenia. Conclusion: Second-line carboplatin-based chemotherapy of ovarian cancer is associated with a low incidence of serious thrombocytopenia, if a strategy of selecting modest initial dose levels, and instituting rapid reductions in dose with the development of significant bone marrow suppression, is employed.