{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T23:37:59Z","timestamp":1790811479208,"version":"4.1.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T00:00:00Z","timestamp":1737504000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100016036","name":"Health~Holland","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016036","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Thrombocytopenia is a major temozolomide-induced adverse event during the standard treatment of glioblastoma. Consequently, platelet transfusions and treatment modifications may impact quality of life and long-term treatment outcomes. Understanding the impact of thrombocytopenia on healthcare utilization is crucial to mitigate the need for healthcare resources in glioblastoma patients. Here, we assess the influence of thrombocytopenia-related healthcare among patients diagnosed with glioblastoma.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We retrospectively collected patient information treated at the Brain Tumor Center Amsterdam between 2008 and 2021. The occurrence of thrombocytopenia, patient demographics, treatment details, and healthcare utilization data were gathered from patients who received standard glioblastoma treatment. Associations between temporal severity of thrombocytopenia as categorized by the Common Terminology Criteria for Adverse Events, patient characteristics, and healthcare utilization were analyzed using Generalized Linear Mixed Models.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We included 206 patients with a median age of 58 years, 35.9% were female and we found that thrombocytopenia (any grade) occurred in 61.1% of patients. The occurrence of thrombocytopenia during CRT was associated with increased healthcare utilization and was largest in females who developed grade 4 thrombocytopenia compared to those who did not develop thrombocytopenia (OR\u2005=\u20055.9, P\u2005&amp;lt;\u2005.001 in females vs OR\u2005=\u20054.4, P\u2005&amp;lt;\u2005.001 in males). Grade 4 thrombocytopenia was also associated with heightened healthcare utilization during the adjuvant phase (OR\u2005=\u20057.6, P\u2005&amp;lt;\u2005.001), and was comparable between sexes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Severe thrombocytopenia during glioblastoma treatment is linked to increased healthcare utilization, disproportionally impacting females. These data suggest that prevention and early management of thrombocytopenia can reduce healthcare utilization in patients with glioblastoma.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/nop\/npaf013","type":"journal-article","created":{"date-parts":[[2025,1,20]],"date-time":"2025-01-20T15:19:31Z","timestamp":1737386371000},"page":"678-690","source":"Crossref","is-referenced-by-count":1,"title":["Severe temozolomide-induced thrombocytopenia is linked to increased healthcare utilization in glioblastoma and disproportionally impacts female patients"],"prefix":"10.1093","volume":"12","author":[{"given":"Leon","family":"van Hout","sequence":"first","affiliation":[{"name":"Cancer Center Amsterdam, Treatment and Quality of Life , Amsterdam ,","place":["The Netherlands"]},{"name":"Amsterdam UMC Location Vrije Universiteit Amsterdam, Neurology , Amsterdam ,","place":["The Netherlands"]},{"name":"Amsterdam UMC Location Vrije Universiteit Amsterdam, Neurosurgery , Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia D","family":"Borgo","sequence":"additional","affiliation":[{"name":"Cancer Center Amsterdam, Treatment and Quality of Life , Amsterdam ,","place":["The Netherlands"]},{"name":"Amsterdam UMC Location Vrije Universiteit Amsterdam, Neurology , Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nienke","family":"Grun","sequence":"additional","affiliation":[{"name":"Cancer Center Amsterdam, Treatment and Quality of Life , Amsterdam ,","place":["The Netherlands"]},{"name":"Amsterdam UMC Location Vrije Universiteit Amsterdam, Neurology , Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maaike","family":"Schuur","sequence":"additional","affiliation":[{"name":"Stichting Epilepsie Instellingen Nederland (SEIN), Neurology , Heemstede ,","place":["The Netherlands"]},{"name":"Cancer Center Amsterdam, Treatment and Quality of Life , Amsterdam ,","place":["The Netherlands"]},{"name":"Amsterdam UMC Location Vrije Universiteit Amsterdam, Neurology , Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martijn P G","family":"Broen","sequence":"additional","affiliation":[{"name":"Department of Neurology, GROW School for Oncology and Reproduction, Maastricht University Medical Center , Maastricht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart A","family":"Westerman","sequence":"additional","affiliation":[{"name":"Cancer Center Amsterdam, Treatment and Quality of Life , Amsterdam ,","place":["The Netherlands"]},{"name":"Amsterdam UMC Location Vrije Universiteit Amsterdam, Neurosurgery , Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imke","family":"Bartelink","sequence":"additional","affiliation":[{"name":"Cancer Center Amsterdam; Imaging and Biomarkers , Amsterdam ,","place":["The Netherlands"]},{"name":"Department of Clinical Pharmacy & Pharmacology , Amsterdam ,","place":["The Netherlands"]},{"name":"Cancer Center Amsterdam, Treatment and Quality of Life , Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William Peter","family":"Vandertop","sequence":"additional","affiliation":[{"name":"Cancer Center Amsterdam, Treatment and Quality of Life , Amsterdam ,","place":["The Netherlands"]},{"name":"Amsterdam UMC Location Vrije Universiteit Amsterdam, Neurosurgery , Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgit I","family":"Lissenberg \u2013 Witte","sequence":"additional","affiliation":[{"name":"Amsterdam UMC Location Vrije Universiteit Amsterdam, Epidemiology and Data Science , Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5252-4365","authenticated-orcid":false,"given":"Mathilde C M","family":"Kouwenhoven","sequence":"additional","affiliation":[{"name":"Cancer Center Amsterdam, Treatment and Quality of Life , Amsterdam ,","place":["The Netherlands"]},{"name":"Amsterdam UMC Location Vrije Universiteit Amsterdam, Neurology , Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,1,22]]},"reference":[{"key":"2025081316521800100_CIT0001","doi-asserted-by":"crossref","first-page":"iii1","DOI":"10.1093\/neuonc\/noab200","article-title":"CBTRUS Statistical Report: primary brain and other central nervous system tumors diagnosed in the United States in 2014-2018","volume":"23","author":"Ostrom","year":"2021","journal-title":"Neuro Oncol"},{"issue":"10","key":"2025081316521800100_CIT0002","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1056\/NEJMoa043330","article-title":"Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma","volume":"352","author":"Stupp","year":"2005","journal-title":"N Engl J Med."},{"issue":"1","key":"2025081316521800100_CIT0003","doi-asserted-by":"crossref","first-page":"e39","DOI":"10.1200\/JOP.18.00319","article-title":"Role of adverse events in unscheduled hospitalizations among patients with solid tumors who receive medical oncology treatment","volume":"15","author":"Wong","year":"2019","journal-title":"J Oncol Pract"},{"issue":"31","key":"2025081316521800100_CIT0004","doi-asserted-by":"crossref","first-page":"e11736","DOI":"10.1097\/MD.0000000000011736","article-title":"Direct costs associated with adverse events of systemic therapies for advanced melanoma: Systematic literature review","volume":"97","author":"Copley-Merriman","year":"2018","journal-title":"Medicine (Baltim)."},{"key":"2025081316521800100_CIT0005","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1093\/annonc\/12.suppl_3.S3","article-title":"Quality of life as a primary end point in oncology","volume":"12","author":"Roila","year":"2001","journal-title":"Ann. 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