Incidence and Risk Factors of Neutropenia in Breast Cancer Patients Receiving Intravenous Chemotherapy at King Chulalongkorn Memorial Hospital
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Abstract
Objective: To study incidence and risk factors of neutropenia in breast cancer patients who received intravenous chemotherapy Methods: This observational retrospective cohort study reviewed the medical records of 380 patients with age ≥18 years old and having pathologically confirmed newly diagnosed breast cancer stage I to III and receiving intravenous chemotherapy for the first time. The association between risk factors and time to occurrence of neutropenia was determined using the Cox proportional hazards regression. Results: Among 380 subjects, 23 received granulocyte-colony stimulating factor (G-CSF) for primary prevention to increase neutrophils. This study excluded this group of patients. The study in 357 patients found the incidence of grade 2–4 chemotherapy induced neutropenia (CIN) with ANC<1.5x109 neutrophils/L was 72.55% (n=259) and the incidence after first cycle of chemotherapy were 57.70% (n=206). Incidence rate was 9.7 per 100 person-weeks. The significant risk factors of CIN was chemotherapy regimen (P=0.002). There was no statistically significant association between time to occurrence of neutropenia and age, body mass index, comorbidities, stage of breast cancer, and baseline laboratory. Patients receiving doxorubicin and cyclophosphamide based regimen (AC based) had 1.7 times higher than those with non-AC based regimen to develop neutropenia. Conclusion: This study found high incidence of grade 2–4 CIN after chemotherapy (72.55%) and more than half of the incidence occurred after receiving first cycle of chemotherapy. Therefore, monitoring and appropriate prevention should be provided in patients receiving first cycle of chemotherapy or AC-based regimen.
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ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
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