Pharmacologic markers predictive of neutropenia chemically induced by cisplatin (CDDP)

The aim of this study was to demonstrate the value of the level of platinum in lymphocytes, plasma and saliva, in order to predict neutropenia during the same cycle after cisplatin chemotherapy. Plasma and lymphocytes samples were obtained from 14 patients receiving 100 mg/m2 cisplatin in different combination. Saliva samples were obtained from 3 other patients. We found that platinum plasma concentration at the Cmax and 1 hour after the end of the infusion were significantly higher in the grade 4 neutropenia cycles (respectively 2.60 vs 2.05 and 2.55 vs 2.00 mg/l p < 0.05). Platinum DNA-adduct were not detectable by ICPMS. Maximum concentrations in saliva ranged between 0.05 to 0.08 mg/l at the end of the infusion. The ratio of platinum levels in plasma and saliva varied between 2 and 3%. Saliva seems to be useful for therapeutic drug monitoring of cisplatin because it can be obtained by non invasive and patient-friendly-means. However, new studies are required to demonstrate the relationship between these two biological fluids.