The occurrence and risk factors of chemotherapy-induced neutropenia in patients with breast cancer not receiving primary G-CSF prophylaxis

Hutajulu, Susanna Hilda and Oktariani, Siswi and Sunggoro, Agus Jati and Bintoro, Bagas Suryo and Astari, Yufi Kartika and Wiranata, Juan Adrian and Widodo, Irianiwati and Ekowati, Anita and Hardianti, Mardiah Suci and Taroeno-Hariadi, Kartika Widayati and Kurnianda, Johan and Purwanto, Ibnu (2023) The occurrence and risk factors of chemotherapy-induced neutropenia in patients with breast cancer not receiving primary G-CSF prophylaxis. ecancermedicalscience, 17. ISSN 17546605

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Abstract

Background: Chemotherapy-induced neutropenia (CIN) is a substantial side effect in chemotherapy of breast cancer patients. Administration of granulocyte colony stimulating factor (G-CSF) that may reduce CIN occurrence is not commonly available to many local cases. Objectives: To investigate the occurrence of grade 4 CIN and the influencing factors in breast cancer patients not receiving G-CSF prophylaxis. Methods: One-hundred and eighty-six newly diagnosed breast cancer patients who received a 3-weekly (neo)adjuvant or palliative chemotherapy without primary G-CSF prophylaxis were included. Grade 4 CIN was defined as absolute neutrophil count (ANC) <0.5 × 103/mm3 during any chemotherapy cycle. We used logistic regression to explore the association of clinical, pathological and treatment factors with the risk of grade 4 CIN in the first cycle and in any given cycle. Results: Fifty-seven (30.6) patients experienced grade 4 CIN in the first cycle and 145 (78) had it at least once during chemotherapy. In the first cycle, haemoglobin, ANC, and albumin levels were associated with grade 4 CIN (OR = 1.48, p = 0.031; OR = 0.68, p = 0.006; and OR = 2.07, p = 0.042). In any cycle, pre-treatment ANC levels and anthracycline-taxane combination regimen were associated with grade 4 CIN (OR = 0.78, p = 0.032 and OR = 3.64, p = 0.012). Conclusions: A significant proportion of the local breast cancer cases undergoing chemotherapy without primary G-CSF prophylaxis experienced grade 4 CIN. Haemoglobin, ANC, and albumin levels are the risk factors for first cycle CIN, while pre-treatment ANC levels and anthracycline-taxane chemotherapy regimen are associated with CIN in any given cycle. These risk factors may be used to direct a recommendation of G-CSF prophylaxis to the most at-risk individuals in the local setting or other settings in similar situations. Copyright: © the authors; licensee.

Item Type: Article
Additional Information: Cited by: 0; All Open Access, Gold Open Access
Uncontrolled Keywords: carboplatin; cyclophosphamide; docetaxel; doxorubicin; epirubicin; granulocyte colony stimulating factor; hemoglobin; paclitaxel; absolute neutrophil count; adult; aged; Article; breast cancer; chemotherapy induced neutropenia; cohort analysis; disease severity; drug induced disease; drug safety; female; human; major clinical study; neoadjuvant chemotherapy; neutropenia; palliative chemotherapy; pathology; prophylaxis; risk factor
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions: Faculty of Medicine, Public Health and Nursing > Public Health and Nutrition
Depositing User: Mukhotib Mukhotib
Date Deposited: 23 Aug 2024 03:14
Last Modified: 23 Aug 2024 03:14
URI: https://ir.lib.ugm.ac.id/id/eprint/2866

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