Haematological toxicity in breast cancer patients on epirubicin/cyclophosphamide, taxane chemotherapy at the university college hospital Ibadan, Nigeria

Abstract

Background: Chemotoxicity is a major cause of morbidity amongst breast cancer patients undergoing therapy with haematologic toxicity being the commonest.

Objective: To evaluate the haematological toxicities experienced by breast cancer patients on chemotherapy in a tertiary institution in Nigeria

Design: A prospective case-control study done over 5 years

Setting: Oncological Surgery Division of the University College Hospital Ibadan, Nigeria

Subjects: All female breast cancer patients who had at least a total of six courses of chemotherapy as neoadjuvant and/or adjuvant.

Intervention: Chemotherapy was administered using the National Comprehensive Cancer Network guideline.

Main Outcome measures: Demographical profiles, stage at presentation, histology, serial haemograms. Data collected using a questionnaire screened and entered and analysed using SPSS version 20.

Results: Out of the 910 patients reviewed, 218 (24%) patients were included in the analysis. The median age was 44 years. 54% were premenopausal, while 46% were postmenopausal. Of these 83.9% presented with advanced disease. A total of 92 (42%) patients had neoadjuvant chemotherapy, 83 (38.1%) had adjuvant chemotherapy while 43 (19.7%) given palliation treatment. Myelosuppression was the commonest, particularly neutropenia noted in 54(25%) patients, anaemia occurred in 33 (15%) and thrombocytopenia in 1 (0.5%). Febrile neutropenia occurred in 19 patients who required in-hospital care. One (0.5%) patient died from febrile neutropenia. Toxicity occurred more towards the latter half of chemotherapy especially with the use of taxanes.

Conclusion: Taxanes use in these facilities were associated with hematologic toxicity that occurred in the last half of taxanes chemotherapy. Leukopenia with febrile neutropenia most common complication.