Klin Onkol 2006; 19(6): 299-304.
Summary
Background: Hematologic toxicity belongs to the most common adverse effects of cancer chemotherapy and can lead to serious iatrogenic harm of the patient. Lithium is traditionally used for prophylaxis and treatment of chemotherapy induced neutropenia, because its application induces a reversible leucocytosis. Recent investigations demonstrate that Lithium inhibits apoptosis and stimulates cell proliferation through a direct effect on GSK-3ß and Akt/PKB kinase. Simultaneously, both kinases are playing an important role in survival process and chemoresistance of tumor cells.
Material, methods: In 53 primary tumors we carried out 151 MTT tests of chemoresistance to selected cytotoxic drugs with presence or absence of Lithium. In a group of 106 patients the Lithium effect on hematopoiesis and on a development of cancer was evaluated. We analyzed 349 pair-examinations of blood counts and measured the time to progression.
Results: We demonstrated an enormous increase in chemoresistance of primary in-vitro tested tumors to doxorubicin (p<0,0001) and paclitaxel (p<0,0003) in the presence of Lithium. In a selected group of patients we demonstrated that a higher rate of Lithium applications leads to early disease progression (p=0,0061). Lithium administration resulted in increased count of leukocytes and neutrophiles, but the effect was not significant.
Conclusion: Administration of Lithium for prophylaxis and treatment of chemotherapy induced neutropenia is unjustified and causes increased tumor chemoresistance.
