Haematological toxicity from post-prostatectomy whole pelvis radiotherapy has been described in literature. Lymphopenia has been observed with conventional fractionation and neutropenia with hypofractionation. Aim of this analysis was to address severity and duration of haematological toxicity from whole pelvis radiotherapy for prostate cancer.
We have monitored the counts of absolute white blood cells, lymphocytes, neutrophils, platelets and haemoglobin in 9 patients wit high risk prostate cancer undergoing whole pelvis radiotherapy. All baseline values were within normal ranges. Prescribed dose on pelvic lymph nodes was 46Gy, on seminal vesicles 56 Gy and on prostate 74 Gy, 2 Gy per fraction, 5 days/ week. In all patients treatment started with whole pelvis irradiation. All patients received androgen deprivation therapy; 2 patients antiandrogen only and 7 patients antiandrogen with LHRH agonist. Complete blood sample was obtained before the beginning of radiotherapy and then weekly during the treatment.
In all patients persistent decline of absolute white blood cells count (WBC) and haemoglobine level (Hb) was observed (WBC till 3,28x 109/L, Hb till 104 g/L). No change in neutrophil and platelate counts was noticed. A significant decline of lymphocyte count was observed in all patients, both in absolute values and percentages with nadir between 0,39 and 0.79x 109/L (median 0,54x 109/L). Lymphopenias occurred from 5th week of radiotherapy onwards, with doses of 44 till 66 Gy (median 52 Gy), hence 30 till 45 days from the beginning of whole pelvis radiotherapy (median 36th day). By the end of radiotherapy lymphocyte counts gradually increased, but referent values were not reached (1,19- 3,35x 109/L). All observed lymphopenias were asymptomatic.
