Predictive Factors For Neutropenia During Chemotherapy Treatment In Breast Cancer Patients
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Date
2017-06
Authors
Ong, Chiew Wai
Journal Title
Journal ISSN
Volume Title
Publisher
Universiti Sains Malaysia
Abstract
Background and objective: Neutropenia caused by chemotherapy treatment can frequently lead to severe infection and sometimes life-threatening. It may result in dose reductions, delays or discontinuation of chemotherapy which may subsequently compromise patient outcomes. The aim of this study was to determine the incidence of neutropenia and predictive factors for neutropenia during chemotherapy treatment in breast cancer patients.
Study design and methods: This was a single-centre, retrospective study conducted in the Advanced Medical and Dental Institute (AMDI), Penang. All breast cancer patients who received chemotherapy treatment from January 2014 to December 2016 were included into the study. Ethical approval was granted by the JEPeM USM. The association between patient’s demographic factors, disease-related factors and treatment-related factors with incidence of neutropenia were analysed. Chi-square tests, Fisher’s Exact Test, Simple and Multiple Logistic Regression Model were used for data analysis.
Results: One hundred and fifty-five patients were analysed in this study, with the mean (SD) age of 52.19 (9.46) years. In total, 85 patients (54.8%) manifested neutropenia and sub-categorisation of neutropenia based on severity, showed mild neutropenia (25.8%), moderate neutropenia (12.9%), severe neutropenia (9.0%) and febrile neutropenia (7.1%). Descriptive analysis showed that majority of patients in this study were aged 40 – 59 years (62.6%),
overweight (67.1%), postmenopause (60.6%), no family history of breast cancer (85.8%), ductal pathology subtype
(94.8%), receptor subtype of ER- or PR- Positive (43.4%), late cancer stage (58.4%), underwent mastectomy surgery (79.3%), received Anthracycline-Taxane Chemotherapy Regimens (66.5%) and received G-CSF treatment (67.1%). All breast cancer patients were female in the present study. From Simple Logistic Regression, variables that have predictive value to neutropenia were body mass index (BMI) ≥ 23kg/ m2 or overweight group (p = 0.012) and did not receive G-CSF (p = 0.018). In multivariable analysis, patient’s BMI (B = -1.071, aOR = 0.34, 95% CI 0.16, 0.76, p = 0.008) and receive status of G-CSF (B = -0.852, aOR=0.43, 95% CI 0.22, 0.85, p = 0.015) were the significant associated predictive factors for neutropenia during chemotherapy treatment in breast cancer patients.
Conclusions: The incidence of neutropenia in this study centre was comparable with other centres. Our study had identified the associated predictive factors for neutropenia in breast cancer patients. However, further studies involved multi-centre, prospective and bigger cohort are highly recommended to establish local predictive model for neutropenia in breast cancer patients.
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Keywords
Predictive factors for neutropenia during chemotherapy , treatment in breast cancer patients