PURPOSE: Systemic inflammatory changes develop after intrapleural instillation of chemical agents for pleurodesis. The underlying mechanisms of pleurodesis after intrapleural catheter (IPC) placement in cancer patients with pleural effusion are still to be determined. The objective of the study was to compare changes in peripheral white blood cell count, serum LDH and total protein during the first week after IPC insertion in cancer patients with pleural effusion, attaining and not attaining pleurodesis.
METHODS: Retrospective chart review of patients with cancer and pleural effusion undergoing IPC placement. CBC, serum LDH and protein prior and within one week post procedure were obtained. Pleurodesis was defined as long term relief of symptoms related to effusion with absence of fluid reaccumulation on chest radiographs until last follow up or death. Differences between baseline and follow up values were compared according to pleurodesis success or failure.
RESULTS: Data on 89 patients were analyzed (median age = 59 years, male = 57%). The primary tumors were non-small cell lung cancer (40%), breast cancer (10%), other solid tumors (24%), and hematologic malignancies (26%). The incidence of pleurodesis was 41%. Median interval between baseline and follow up blood samples was 2 days. None of the evaluated chemical or cellular markers showed significant changes after IPC insertion (protein 6.56 g/dl vs. 6.41 g/dl; LDH 950 u/dl vs. 1019 u/dl; total WBC count 8,704/uL vs. 10,589/u/L; polymorphonuclear leukocyte percentage 76% vs. 78%), neither between patients attaining or not attaining pleurodesis.
CONCLUSION: There was no significant change in common systemic inflammatory markers after IPC insertion. Additional studies with serial measurement of more sensitive systemic and pleural inflammatory markers are warranted.
CLINICAL IMPLICATIONS: In order to further understand the underlying mechanisms of pleurodesis after intrapleural catheter (IPC) placement, additional studies are necessary.
DISCLOSURE: Carlos Martinez, Other The Department of Pulmonary Medicine at M. D. Anderson Cancer Center is the recipient of an unrestricted donation from Cardinal Health Medical Products and Services Corporation to support clinical research.; No Product/Research Disclosure Information