Chemotherapy Induced Neutropenia in Palestinian Patients with Solid Malignancies: Patient Characteristics, Severity Risk Factors & Management Patterns

Abstract

Neutropenia is an adverse event of systemic chemotherapy with various complications that impact patient management, quality of life, and could be fatal. The study was conducted to evaluate chemotherapy-induced-neutropenia in a Palestinian cohort of patients with solid malignancies. This paper examines patient characteristics, risk factors for neutropenia severity and management patterns. The study included a total of 171 adult patients diagnosed with solid malignancies, and were on their first chemotherapy regiments with no history of neutropenia. Data was collected retrospectively from patients' electronic medical records. Only patients who developed neutropenia during treatment were included in this study, and were classified into three groups of severity based on the absolute neutrophil count. Colon cancer and lung cancer were the most reported. Epirubicin, paclitaxel, cyclophosphamide, and doxorubicin were significantly associated with neutropenia severity, in addition to the number of chemotherapy cycles, stage at diagnosis and certain comorbidities. 32.5% of patients reported substance use which was also significantly associated with severity. The majority of patients received primary GCSF prophylaxis. 69% of patients presented with febrile neutropenia. Hospitalization, antibiotics, antipyretics, and GCSF were utilized for management in most patients. Neutropenia severity was associated with the chemotherapy agents used, while the type of solid malignancy was not. Substance use represented a high burden among our cohort, and its association with severity could be further studied. Primary GCSF prophylaxis is critical with patients not receiving it developing profound neutropenia (absolute neutrophil count < 0.1 x 109) at higher rates.