Myelosuppression is major treatment-related adverse events of
linezolid therapy and result in treatment termination in some cases. We aimed to identify the risk factors for
linezolid-induced
thrombocytopenia and
anemia. We retrospectively retrieved demographic and laboratory data from the medical records of 221 Japanese patients who were undergoing
linezolid therapy.
Thrombocytopenia and
anemia were defined as an unexplained reduction of >30% in the patient's platelet count and
hemoglobin level, respectively, from the baseline.
Thrombocytopenia developed in 48.4% of patients, and
anemia developed in 10.4% of patients during
linezolid therapy. In multivariate analysis,
creatinine clearance (adjusted odds ratio = 0.94 [0.92-0.95], P < 0.001),
hemodialysis (3.32 [1.14-9.67], P = 0.011), and the duration of
linezolid therapy (1.14 [1.07-1.21], P < 0.001) were found to be significant risk factors for
linezolid-induced
thrombocytopenia. Patients with
creatinine clearance rates of <60 mL/min and those on
hemodialysis were found to be at high risk of
linezolid-induced
thrombocytopenia. In addition, a high incidence of
linezolid-induced
thrombocytopenia was even detected among the patients that had received
linezolid therapy for <7 days. As for
anemia, the duration of
linezolid therapy (1.04 [1.01-1.07], P = 0.011) was shown to be a risk factor for
anemia, and a high incidence of
anemia was seen among the patients who received
linezolid for >15 days. In conclusion, we recommend that among patients receiving
linezolid therapy the platelet counts of those with risk factors for
linezolid-induced
thrombocytopenia should be monitored closely throughout treatment, and the
hemoglobin levels of patients that receive
linezolid for >15 days should be carefully monitored on a weekly basis to detect
anemia.