Hematologic Toxicities and Determinants Among Patients With Breast Cancer Treated With Doxorubicin–Cyclophosphamide Followed by Paclitaxel in Northwest Ethiopia: A Retrospective Cohort Study
Tegenu Chanie Tesfaye, Rahel Belete Abebe, Gashaw Binega Mekonnen, Ephrem Tafesse Teferi, Mekonnen Melkie Bizuneh, Ashenafi Kibret Sendekie, Tigabu Eskeziya Zerihun, Desalegn Addis Mussie, Abel Temeche Kassaw, Samuel Agegnew WondmABSTRACT
Background and Aim
Hematologic toxicities are common during breast cancer chemotherapy, but data from Ethiopia are limited. This study assessed hematologic toxicities and associated factors among patients treated with doxorubicin‐cyclophosphamide followed by paclitaxel (ACT) regimen in Northwest Ethiopia.
Methods
A retrospective cohort study was conducted among 422 patients with breast cancer treated with the AC‐T regimen from January 2019 to August 2023 in Northwest Ethiopia. Data were collected from July to August 2023. Factors associated with hematologic toxicities were identified using binary logistic regression, with adjusted odds ratio (AOR), 95% confidence interval (CI), and a two‐sided p < 0.05 indicating statistical significance.
Results
Among 422 patients, the prevalence of chemotherapy‐induced neutropenia (CIN), chemotherapy‐induced anemia (CIA), chemotherapy‐induced thrombocytopenia (CIT), and neutropenic fever (NF) was 61.8%, 44.1%, 16.4%, and 10.0%, respectively. Older age (≥ 43 years) (AOR = 3.5, 95% CI: 2.2–5.7, p = 0.012) and rural residence (AOR = 3.4, 95% CI: 2.9–8.7, p = 0.032) were independently associated with CIN. Advanced cancer stage was associated with FN, with higher odds among patients with stage IV (AOR = 4.4, 95% CI: 1.9–9.6, p = 0.001) and stage III disease (AOR = 2.8, 95% CI: 1.6–8.2, p = 0.016). CIA was significantly associated with mixed histology (AOR = 3.3, 95% CI: 1.3–8.7, p = 0.015), lobular histology (AOR = 1.7, 95% CI: 1.1–2.8, p = 0.033), stage III cancer (AOR = 2.5, 95% CI: 1.2–5.5, p = 0.017) and stage IV cancer (AOR = 3.4, 95% CI: 1.1–10.3, p = 0.028), and comorbidities (AOR = 1.8, 95% CI: 1.1–3.1, p = 0.040). CIT was associated with older age (≥ 43 years) (AOR = 2.8, 95% CI: 1.4–5.9, p = 0.005), rural residence (AOR = 4.8, 95% CI: 1.6–14.4, p = 0.003), stage III (AOR = 2.8, 95% CI: 1.1–7.0, p = 0.028), and stage IV disease (AOR = 4.5, 95% CI: 1.4–10.1, p = 0.013).
Conclusions
Hematologic toxicities were common with the ACT regimen and associated with older age, rural residence, advanced stage, comorbidities, and lobular/mixed histology, warranting close monitoring.