Adjuvant chemotherapy (CMF) for breast carcinoma: hematological side effects

Seventy-five patients accepted postmastectomy adjuvant CMF chemotherapy for stage II and III carcinoma of the breast. All patients, irrespective of age, were started on the same drug dosages. About 42% of the patients had leukopenia during the first two cycles; this rate was similar for patients who dropped out of the program early and those who stayed on for six or more months. Patients who developed leukopenia early are more likely to receive less than 65% of mean total CMF dosages (MTD). Otherwise, 30% of patients that never had leukopenia or had leukopenia that appeared late received more than 85% of the prescribed CMF. In our series, postmenopausal patients did not have more problem with leukopenia than premenopausal patients (thrombocytopenia occurred rarely in both groups). Among the 58 patients who had CMF for 6 months or longer, 79% had less than 85% MTD or CMF. The dosages had to be reduced for drug-related and other reasons, and leukopenia only accounted for 22% of patients who had reduced CMF dosages.