Risk factors associated neutropenia and prevention strategies in colorectal cancer patients undergoing chemotherapy

Abstract

Neutropenia is a common adverse effect in patients undergoing chemotherapy, leading to treatment delays, prolonged therapy duration, and an increased risk of severe infections. This study aims to identify factors associated with neutropenia and develop preventive measures in colorectal cancer patients receiving intravenous chemotherapy. The study included 261 colorectal cancer patients receiving intravenous chemotherapy at the chemotherapy unit of Nan hospital from January 1, 2021, to April 30, 2024. Patient history data were collected from medical records and analyzed using descriptive statistics and logistic regression. The results indicated that 168 patients (64.37%) experienced neutropenia, with 128 patients (49.04%) having at least one episode of grade 2 or higher severity (ANC<1,500 cells/mm²). Factors significantly associated with grade 2 or higher neutropenia included female gender OR=2.47; 95%CI: 1.44-4.23; P=0.001), stage 3 cancer (OR=2.61; 95%CI: 1.18-5.72; P=0.017), FOLFOX4 chemotherapy regimen (OR=6.61; 95%CI: 1.27-34.47; P=0.025) The multidisciplinary team collaboratively developed preventive measures implemented in the unit. Proactive measures include dose reduction of chemotherapy or administration of G-CSF in female patients receiving FOLFOX4 regimens. Reactive measures involve educating and promoting appropriate self-care practices to prevent and reduce the risk of severe neutropenia. These strategies aim to enhance treatment efficacy and improve patients' quality of life