gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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Dexamethasone-induced leukocytosis is associated with poor survival in newly diagnosed glioblastoma

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  • Daniel Dubinski - Klinik für Neurochirurgie, Universitätsklinikum Frankfurt, Frankfurt am Main, Deutschland
  • Sae-Yeon Won - Klinik für Neurochirurgie, Universitätsklinikum Frankfurt, Frankfurt am Main, Deutschland
  • Florian Gessler - Klinik für Neurochirurgie, Universitätsklinikum Frankfurt, Frankfurt am Main, Deutschland
  • Johanna Quick-Weller - Klinik für Neurochirurgie, Universitätsklinikum Frankfurt, Frankfurt am Main, Deutschland
  • Bedjan Behmanesh - Klinik für Neurochirurgie, Universitätsklinikum Frankfurt, Frankfurt am Main, Deutschland
  • Kea Franz - Klinik für Neurochirurgie, Universitätsklinikum Frankfurt, Frankfurt am Main, Deutschland
  • Volker Seifert - Klinik für Neurochirurgie, Universitätsklinikum Frankfurt, Frankfurt am Main, Deutschland
  • Christian Senft - Klinik für Neurochirurgie, Universitätsklinikum Frankfurt, Frankfurt am Main, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocMi.28.01

doi: 10.3205/17dgnc558, urn:nbn:de:0183-17dgnc5581

Published: June 9, 2017

© 2017 Dubinski et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Despite its well-characterized side effects, dexamethasone is widely used in the pre- peri- and postoperative neurosurgical setting due to its fast and effective release of tumor side effects through the reduction of tumor-associated oedema. However, some patients show laboratory-defined dexamethasone induced elevation of white blood cell count without obvious clinical significance.

Methods: We retrospectively analyzed 113 patients with newly diagnosed glioblastoma to describe the incidence, risk factors and clinical features of dexamethasone-induced leucocytosis in primary GBM patients.

Results: Among all patients with preoperative dexamethasone administration, the presence of manifest dexamethasone-induced leucocytosis significantly decreased overall survival (p= 0.009 HR: 2.25 KI: 1.15 , 4.38). Similar results were obtained for progression free survival. (p=0.028 HR: 2.23 KI: 1.09 – 4.59). We further detected patient’s age as a positive prognostic factor for DIL development. (p=0.033)

Conclusion: We identified an early novel prognostic marker in GBM induced oedema management and characterized a subgroup, which would probably benefit from other oedema reducing substances in the course of GBM treatment.