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@ARTICLE{Oster:307554,
      author       = {C. Oster$^*$ and P. Reineck and T. Schmidt and J. Grieger
                      and S. Sharma and J. Feldheim and K. Kizina and G. Cappello
                      and L. Jekel and K. M. Pabst$^*$ and Y. Ahmadipour and H.
                      Karadachi and L. Rauschenbach$^*$ and L. Lazaridis and N.
                      Guberina and C. Pöttgen and T. Blau and K. Keyvani and B.
                      Scheffler$^*$ and K. Herrmann$^*$ and C. Kleinschnitz and U.
                      Sure and M. Stuschke and M. Glas$^*$ and S. Kebir$^*$},
      title        = {{D}istribution and prognostic significance of myelotoxicity
                      in newly diagnosed glioblastoma in a real-life cohort:
                      {T}ime to treat more aggressively?},
      journal      = {Neuro-oncology advances},
      volume       = {7},
      number       = {1},
      issn         = {2632-2498},
      address      = {Oxford},
      publisher    = {Oxford University Press},
      reportid     = {DKFZ-2026-00051},
      pages        = {vdaf218},
      year         = {2025},
      note         = {Published:05 December 2025},
      abstract     = {Glioblastoma represents one of the most aggressive and
                      fatal primary brain tumors in adults. Chemotherapeutic
                      agents, while integral to management, frequently induce
                      varying levels of myelotoxicity. The aim is to investigate
                      the clinical impact of myelotoxicity in patients treated
                      with the CeTeG versus the Stupp regimen which has not yet
                      been systematically investigated under real-world
                      conditions.This retrospective study included patients with
                      newly diagnosed glioblastoma who underwent
                      radiochemotherapy. Peripheral blood counts were
                      systematically assessed throughout first-line therapy,
                      starting at the initiation of radiation and continuing until
                      either first disease progression or death, whichever
                      occurred earlier.Among 161 identified patients, 133 $(83\%)$
                      were assigned to the myelotoxicity cohort and 28 $(17\%)$ to
                      the non-myelotoxicity cohort. Female sex was independently
                      associated with a higher incidence of myelotoxicity (p =
                      0.007). In multivariate analysis leukopenia ≥ grade 2 was
                      significantly associated with improved progression-free and
                      overall survival in both the overall and CeTeG cohorts.
                      Neutropenia ≥ grade 2 similarly correlated with improved
                      survival outcomes in the overall cohort. Prophylaxis against
                      pneumocystis jiroveci pneumonia was associated with a
                      significant survival advantage in both the overall and Stupp
                      cohorts, as was lymphopenia grade 3-4.Myelotoxicity at the
                      time of glioblastoma diagnosis does not seem to be
                      detrimental to patient outcomes. Our findings highlight the
                      importance of pneumocystis jiroveci prophylaxis in the Stupp
                      regimen. This raises the intriguing question of whether
                      future chemotherapy dosages could be tailored based on
                      individual blood values, potentially exceeding current
                      standard doses. Prospective studies are needed to explore
                      these possibilities, including the feasibility of high-dose
                      therapies similar to those used in leukemia treatment.},
      keywords     = {Pneumocysitis jirovecii prophylaxis (Other) /
                      gender-specific medicine (Other) / glioblastoma (Other) /
                      myelotoxicity (Other) / survival (Other)},
      cin          = {ED01},
      ddc          = {610},
      cid          = {I:(DE-He78)ED01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:41497453},
      pmc          = {pmc:PMC12768505},
      doi          = {10.1093/noajnl/vdaf218},
      url          = {https://inrepo02.dkfz.de/record/307554},
}