Chemotherapy-Induced Neutropenia in Palestinian Patients with Solid Malignancies: Patient Characteristics, Severity...

Area of Science:

• Oncology
• Hematology
• Clinical Pharmacy

Background:

• Neutropenia is a significant adverse event of systemic chemotherapy, impacting patient outcomes and survival.
• Understanding risk factors and management patterns is crucial for mitigating neutropenia's complications.

Purpose of the Study:

• To evaluate chemotherapy-induced neutropenia in a Palestinian cohort with solid malignancies.
• To identify patient characteristics, risk factors for neutropenia severity, and current management strategies.

Main Methods:

• Retrospective analysis of electronic medical records from 171 adult patients with solid malignancies receiving their first chemotherapy regimen.
• Classification of neutropenia severity based on absolute neutrophil count.
• Analysis of associations between patient characteristics, chemotherapy agents, comorbidities, substance use, and neutropenia severity.

Main Results:

• Colon and lung cancers were most prevalent. Epirubicin, paclitaxel, cyclophosphamide, and doxorubicin were linked to increased neutropenia severity.
• Higher chemotherapy cycles, advanced stage at diagnosis, comorbidities, and substance use (32.5% of cohort) were associated with neutropenia severity.
• 69% of patients experienced febrile neutropenia; management included hospitalization, antibiotics, antipyretics, and G-CSF. Primary G-CSF prophylaxis was common and associated with lower rates of profound neutropenia.

Conclusions:

• Neutropenia severity is primarily associated with chemotherapy agents and patient-specific factors like substance use, not the type of solid malignancy.
• Substance use poses a significant burden and warrants further investigation regarding its impact on neutropenia.
• Primary G-CSF prophylaxis is essential for preventing severe neutropenia in patients undergoing chemotherapy.