thrombocytopenia

Details about this human disease

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Definitions (2)

A blood platelet disease characterized by low a platelet count in the blood., Xref MGI.

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Model-based individual managing of thrombocytopenia during multi-cyclic chemotherapy

HaematoOpt - Individualized model-based managing of the next-cycle thrombopenia of CHOEP/CHOP treated patients based on platelets dynamics during the previous cycles

Abstract (Expand)

Background: Thrombocytopenia is a major side-effect of cytotoxic cancer therapies. The aim of precision medicine is to develop therapy modifications accounting for the individual’s risk. Methodology/Principle … Findings: To solve this task, we develop an individualized bio-mechanistic model of the dynamics of bone marrow thrombopoiesis, circulating platelets and therapy effects thereon. Comprehensive biological knowledge regarding cell differentiation, amplification, apoptosis rates, transition times and corresponding regulations are translated into ordinary differential equations. A model of osteoblast/osteoclast interactions was incorporated to mechanistically describe bone marrow support of quiescent cell stages. Thrombopoietin (TPO) as a major regulator is explicitly modelled including pharmacokinetics and –dynamics of TPO injections. Effects of cytotoxic drugs are modelled by transient depletions of proliferating cells. To calibrate the model, we used population data from the literature and close-meshed individual data of N=135 high-grade non-Hodgkin’s lymphoma patients treated with CHOP-like chemotherapies. To limit the number of free parameters, several parsimony assumptions were derived from biological data and tested via Likelihood methods. Heterogeneity of patients was explained by a few model parameters. The over-fitting issue of individual parameter estimation was successfully dealt with a virtual participation of each patient in population-based experiments. The model qualitatively and quantitatively explains a number of biological observations such as the role of osteoblasts in explaining long-term toxic effects, megakaryocyte-mediated feedback on stem cells, bi-phasic stimulation of thrombopoiesis by TPO, dynamics of megakaryocyte ploidies and non-exponential platelet degradation. Almost all individual time series could be described with high precision. We demonstrated how the model can be used to provide predictions regarding individual therapy adaptations. Conclusions: We propose a mechanistic thrombopoiesis model of unprecedented comprehensiveness in both, biological mechanisms considered and experimental data sets explained. Our innovative method of parameter estimation allows robust determinations of individual parameter settings facilitating the development of individual treatment adaptations during chemotherapy.

Authors: Y. Kheifetz, Markus Scholz, Markus Löffler

Date Published: 9th Jun 2017

Publication Type: Not specified

Human Diseases: thrombocytopenia

Citation:

Created: 13th May 2019 at 12:00, Last updated: 7th Dec 2021 at 17:58

Shiny App for managing next-cycle thrombopenia

HaematoOpt - Individualized model-based managing of the next-cycle thrombopenia of CHOEP/CHOP treated patients based on platelets dynamics during the previous cycles

Implementation of recently developed dynamic mathematical models of normal and leukemic hematopoiesis to practically impact clinical decision- making.

Fitting available individual patients information, prediction of next-cycle thrombopenia caused by CHOEP treatment based on the individual fits of the preceeding treatment cycles, changing next-cycle relative dosing, posponement of the next cycle, changing follow-up period, visualization of data and simulation

Creator: Markus Scholz

Submitter: René Hänsel

Model type: Not specified

Model format: R package

Environment: Not specified

Organism: Not specified

Human Disease: thrombocytopenia

Investigations: No Investigations

Studies: No Studies

Resources: No Resources

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Created: 13th May 2019 at 15:02, Last updated: 28th Jan 2022 at 15:21

thrombocytopenia

Details about this human disease

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