The Effect Of Neutropenia On The Delivery Of Chemotherapy In Breast Cancer Patients At Korle Bu Teaching Hospital In Accra, Ghana

Abstract

Introduction: Treatment of breast cancer involves chemotherapy, of which the commonest complication is neutropenia and febrile neutropenia. Neutropenic events interrupt the administration of effective chemotherapy and results in poorer outcomes. This study evaluates the impact of neutropenia on the effective delivery of anthracycline-based chemotherapy in breast cancer patients and identifies those at risk of neutropenic events.
Methods: This is a prospective study of one hundred and ninety patients presenting with breast cancer who received both adjuvant and neoadjuvant chemotherapy from January 2013 to July 2014. Patients received cyclophosphamide, doxorubicin and 5-fluorouracil.
Data collected included baseline absolute neutrophil count and subsequent absolute neutrophil counts on day 10 and day 20 throughout the course of therapy to identify any neutropaenic events. Univariate logistic regression analysis of age, body surface area and ECOG performance was done to determine factors associated with neutropaenia.
Results: The prevalence of neutropenia was 8.7% and that of febrile neutropenia was 0.24%. Body surface area of < 2 m2 and first cycle neutropenia were found to be associated with an increased risk of developing neutropenia.
Conclusion: The prevalence of neutropaenia and febrile neutropaenia in this study was relatively low 8.7% and 0.24% respectively. The only factor found to be associated with neutropenic events is a BSA< 2m2. This study forms a basis for a larger study aimed at identifying predictors and developing a model to predict neutropenia risk in the Ghanaian Population.