Incidence of Febrile Neutropenia in Breast Cancer Patients Treated With Chemotheraphy Protocols From 01.01.2020 to 31.12.2021 in

Željka Cvijetić, Zdenka Gojković, Željko Jovičić, Sanja Kostur, Ilija Baroš, Slađana

Pan European-University Apeiron Banja Luka, Bosnia and Herzegovina,
2University Clinical Center of Republic of Srpska, Banja Luka

ABSTRACT: Febrile neutropenia occurring during chemotherapy was reported to be a predictor of survival in breast
cancer patients. We assessed the incidence of febrile neutropenia induced by chemotherapy. Data from a retrospective
study on the application of chemotherapy protocols in breast cancer patients was reviewed. Analyzing the data,
we can see that out of 81 patients who received chemotherapy, 43 were diagnosed with neutropenia and 4 or 9.3%
of those patients were diagnosed with neutropenia again despite prophylaxis with Granulocyte-colony stimulating
factor (G-CSF). In 4 or 9.3% of patients, further administration of that chemotherapy protocol had to be stopped due
to severity of neutropenia and complications they caused. During the treatment, grade IV neutropenia was diagnosed
in 27 or 63% of patients while grade I neutropenia was diagnosed in 2 or 4.65% of patients. Anemia associated with
neutropenia was also diagnosed in 7 or 16.3% of patients while pancytopenia was diagnosed in 4 or 9.3% of patients,
and thrombocytopenia associated with neutropenia was diagnosed in only one patient. The hazard ratio of febrile
neutropenia presence compared to the absence of such toxicity was adjusted. The cox model was 0.75 (confidence
interval 95% 0.54-0.95; P=0,0189) for grade I neutropenia, 0.63 (0.50-0.78; P<0,0001) for grade II neutropenia and
0.71 (0.51-0.98; P=0.3888) for grades III and IV neutropenia. These results suggest that the occurrence of neutropenia
during chemotherapy is an independent predictor of increased survival in breast cancer patients, while the absence of
such toxicity indicates that the drug doses are not sufficient. Monitoring of febrile neutropenia in patients treated with
chemotherapy may contribute to improved drug efficacy and better survival rate.
Keywords: febrile neutropenia, breast cancer, chemotherapy protocols, side effects
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